J Korean Orthop Assoc.  2011 Jun;46(3):222-230. 10.4055/jkoa.2011.46.3.222.

Analysis about Complications of Hip Arthroplasty in Patients with Chronic Renal Failure on Hemodialysis

• Nho JH
• Choi HS
• Park KH
• Park JS
• Suh YS

• KMID: 2185453
• DOI: http://doi.org/10.4055/jkoa.2011.46.3.222

Abstract

PURPOSE
In general, the results and prognosis of surgical treatment in dialysis patients are poor compared to patients with normal kidney function. This study analyzes the complications in chronic renal failure patients who underwent primary hip arthroplasty for hip fractures and arthropathy. Orthopaedic complications and medical complications were analyzed for a consequential difference.
MATERIALS AND METHODS
Between 2003 and 2008, 38 dialysis patients (40 cases) with chronic renal failure were enrolled with 24 cases of bipolar hemiarthroplasty and 16 cases of total hip arthroplasty. Types and rates of orthopaedic and medical complications were investigated. Patients were classified according to age, gender, duration of dialysis and diabetes mellitus status. Complications were analyzed for each group.
RESULTS
Complications occurred in 15 patients (overall complication rate: 37.5%). Eight patients were died within 1 year (mortality: 20%). Gender and duration of dialysis were not correlated to number of complications. However, there were significant differences according to age (p=0.014) and having diabetes (p=0.026). With regard to mortality, there was no significant difference according to the above classification.
CONCLUSION
Patients on hemodialysis have a high risk of complications after primary hip arthroplasty, especially in elderly patients and diabetic patients. Therefore, we require a full disclosure before recommending hip arthroplasty surgery in dialysis patients, and close postoperative care in patients undergoing dialysis.

Keyword

dialysis; chronic renal failure; arthroplasty; complication; hip

MeSH Terms

Aged
Arthroplasty
Diabetes Mellitus
Dialysis
Disclosure
Hemiarthroplasty
Hip
Hip Fractures
Humans
Kidney
Kidney Failure, Chronic
Postoperative Care
Prognosis
Renal Dialysis

Figure

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  Figure 1 Radiographs of a 77-year-old woman who had diabetic nephropathy undergoing hemodialysis treated with left total hip arthroplasty. (A) Preoperative radiograph shows left hip osteoarthritis. (B) Immediate postoperative radiograph shows missed intraoperative periprosthetic fracture around distal portion of the stem. (C) After 2 months of treating with long leg brace, callus formation was obtained. But after removal of brace, the patient had recurrent dislocation. (D) Revision arthroplasty was done changing the liner to a constrained liner.

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