COMPLICATIONS AFTER TOTAL HIP-ARTHROPLASTY - 10 YEARS EXPERIENCE IN A DEVELOPING-COUNTRY (INDIA)

The complications of total hip arthroplasty are significant and their management in a developing country may be a problem. In a series of 400 hip arthroplasties, we experienced a failure rate of 5.3%, whereas 8.2% of our cases died during this period. The most prominent intraoperative complications were trochanteric fracture (four cases), fissuring of the medial femoral cortex (three cases) and broaching of the lateral femoral cortex in one case. Early complications included hip dislocation (one case), superficial infection (nine cases) and significant urinary infection in those cases that were routinely catheterized. Sciatic nerve injury was detected postoperatively in six cases and lateral popliteal neuropraxia in eight cases. Late complications included deep infection (four cases), thromboembolism (two cases) hip dislocation (three cases) and heterotropic ossification in 43 cases. Significant component loosening was observed in 29 hips, 18 of which were clinically symptomatic and were labelled failures. Two hips showed acetabular migration and three stems showed subsidence of more than 5 mm.