Impact of Preoperative Radiological Assessment on Surgical Outcomes in Orthopedic Procedures: A Retrospective Study.

BACKGROUND: Preoperative radiological assessment plays a crucial role in orthopedic surgery by providing detailed anatomical insights and guiding surgical planning. OBJECTIVE: This study aimed to assess the impact of preoperative radiological assessment on surgical outcomes in patients undergoing orthopedic procedures. METHODS: This retrospective study was conducted at Shaheed Zulfiqar Ali Bhutto Medical University from June 2024 to December 2024, including 143 patients. Imaging quality was classified as adequate or inadequate based on completeness, correct projections, diagnostic clarity, and alignment with surgical objectives. Data extracted from electronic medical records included demographic characteristics, intraoperative parameters (duration of surgery, blood loss), and postoperative outcomes (infection, implant alignment, length of stay, functional recovery). Group comparisons were made using appropriate statistical tests, and 95% confidence intervals (CIs) were calculated for the main outcomes. RESULTS: Out of the 143 patients, 98 (68.5%) had adequate imaging, and 45 (31.5%) had inadequate imaging. The adequately imaged group showed shorter operative time (88.6±17.5 vs. 106.2±21.3 minutes; p<0.001; 95% CI: -25.7 to -9.5) and less blood loss (285.4±64.3 vs. 354.1±77.2 mL; p=0.004; 95% CI: -112.3 to -34.7). Postoperative wound infections occurred in 5/98 (5.1%) vs. 7/45 (15.5%) (p=0.041; 95% CI for difference: -20% to -1.2%), and implant misalignment in 3/98 (3.1%) vs. 6/45 (13.3%) (p=0.026). The adequately imaged group also had a shorter mean hospital stay (4.1±1.3 vs. 5.3±1.6 days; p=0.002) and higher functional recovery scores (84.6±7.2 vs. 77.9±9.1; p=0.009). CONCLUSION: Adequate preoperative radiological assessment is associated with improved surgical efficiency, reduced complications, and improved postoperative outcomes in orthopedic procedures. These findings support the routine implementation of structured imaging protocols as a standard of care in orthopedic surgical planning.