gms | German Medical Science

German Congress of Orthopaedics and Traumatology (DKOU 2019)

22. - 25.10.2019, Berlin

Results of Hip Arthroplasty in Patients with Chronic Failure on Dialysis

Meeting Abstract

  • presenting/speaker Tae Woo Kim - Pusan National University Yangsan Hospital, Yangsan, South Korea
  • Won Chul Shin - Pusan National University Yangsan Hospital, Yangsan, South Korea
  • Jung Sub Lee - Pusan National University Hospital, Busan, South Korea
  • Nam Hoon Moon - Pusan National University Hospital, Busan, South Korea
  • Seung Min Son - Pusan National University Yangsan Hospital, Yangsan, South Korea
  • Kuen Tak Suh - Pusan National University Yangsan Hospital, Yangsan, South Korea

Deutscher Kongress für Orthopädie und Unfallchirurgie (DKOU 2019). Berlin, 22.-25.10.2019. Düsseldorf: German Medical Science GMS Publishing House; 2019. DocAB37-124

doi: 10.3205/19dkou279, urn:nbn:de:0183-19dkou2790

Published: October 22, 2019

© 2019 Kim et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.


Outline

Text

Objectives: The purpose of this study was to analyze the radiological and clinical outcomes and complications of primary hip arthroplasty in chronic renal failure patients undergoing dialysis.

Methods: This study analyzed outcomes of 29 hips including 19 hips of total hip arthroplasty and 10 hips of bipolar hemiarthroplasty using cementless acetabular cups and cementless stems with proximally porous-coated and cemented stems in two time periods: within 1 year of surgery and after more than 1 year after surgery. We examined 27 chronic renal failure patients undergoing dialysis (29 hips) out of a total of 1767 hips treated with primary hip arthroplasty between January 2003 and December 2015. The mean patient age was 61.1 years, including 11 male and 16 female patients. The mean follow-up period was 42.2 months. The mean T score, representing bone mineral density, was -2.82, including 24 hips of osteoporosis.

Results and conclusion: With cementless acetabular cups, radiological findings showed infection-induced changes of inclination in one hip; no other implant migrations were observed. Changes in femoral stems, subsidence, osteolysis, and dissociation were not observed. In the clinical assessment, final results based on the Harris Hip score included 26 „excellent,“ 2 „good,“ and 1 „fair“ hip. Complications developed within 1 year of surgery in 16 hips; of these, local complications developed in 2 hips, with infection of the operative site in 1 hip and dislocation in 1 hip. Systemic complications developed in 14 hips, including systemic infectious complications in 6 hips, aggravated renal failure in 4 hips, pulmonary complications in 3 hips, and venous thromboembolism in 1 hip. There were 3 deaths. Complications developed after more than 1 year after surgery in 16 hips, with no local complications. Among these 16 hips, systemic infectious complications occurred in 10 hips, aggravated renal failure in 4 hips, and other complications in 2 hips. There were 5 deaths after more than 1 year after surgery.

Primary hip arthroplasty in chronic renal failure patients on dialysis showed excellent local radiological and clinical outcomes; however, postoperative systemic complications, including infections and aggravation of kidney disease, can occur. Therefore, more meticulous and thorough preoperative treatment planning and postoperative management are required to reduce the risk of complications.