J Korean Med Sci.  2007 Apr;22(2):223-226. 10.3346/jkms.2007.22.2.223.

Perioperative Risk of Hip Arthroplasty in Patients with Cirrhotic Liver Disease

• Moon YW
• Kim YS
• Kwon SY
• Kim SY
• Lim SJ
• Park YS

• KMID: 1713170
• DOI: http://doi.org/10.3346/jkms.2007.22.2.223

Abstract

We retrospectively reviewed the complete medical records of 30 patients with a diagnosis of liver cirrhosis who had undergone hip arthroplasty at three academic institutions between October 1994 and May 2001. There were 26 males and 4 females with a mean age of 60 yr at index operation. Surgical procedures included 17 primary total hip arthroplasties (THA), 8 bipolar hemiarthroplasties, and 5 revision THAs. According to the Child-Pugh scoring system, 19 cirrhotic patients were categorized as class A, 9 as class B, and 2 as class C. Eight (26.7%) of the 30 patients had one or more perioperative complications. Of these, wound infection was the most common, with a rate of 10% (3 of 30 hips). Other perioperative complications included surgical site bleeding, coagulopathy, encephalopathy, gastrointestinal bleeding, pneumonia, and arrhythmia. Death occurred in 2 (6.7%) of the 30 patients; both were Child-Pugh's C cirrhotics. A higher Child-Pugh score (p=0.0001) and a high level of creatinine (p=0.0499) were associated with significantly increased perioperative complications or death. Our findings suggest that surgeons should be vigilant about perioperative complications in patients with advanced cirrhotic liver disease who undergo hip arthroplasty, albeit the mortality rates are relatively low in less severe cirrhotics.

Keyword

Hip Arthroplasty; Liver Cirrhosis; Perioperative Complications; Risk Factors

MeSH Terms

Surgical Wound Infection/diagnosis/*etiology
Risk Factors
Risk Assessment/*methods
Prosthesis-Related Infections/diagnosis/*etiology
Middle Aged
Male
Liver Cirrhosis/*complications
Humans
Gastrointestinal Hemorrhage/diagnosis/*etiology
Female
Arthroplasty, Replacement, Hip/*adverse effects
Adult
Adolescent

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