Iatrogenic vascular injuries during arthroplasty of the hip

What is it about?

First performed in 1960, total hip replacement (THR) is one of the most common operations successfully performed for the treatment of end stage arthritis of the hip joint. More than 76,500 THRs are performed each year in the UK (In the US, over 300,000(!) cases are performed annually.). As with any surgeries, complications could happen during or after THR. Of these, iatrogenic vascular injuries during THR are rare but when they occur, have serious consequences. These have traditionally been managed with open exploration and repair, but there has been a trend towards percutaneous endovascular management recently. This article is a systematic review of the literature, focusing on whether this therapeutic trend has led to an improvement in the rates of morbidity and mortality after this serious complication.

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Why is it important?

Certainly, vascular injuries during THR are very rare but serious problem, and total number of THRs operated in the world are huge and must be keep on growing for sometimes in the future. In this article, a mortality rate of 7.8%, amputation of 1.8%, and of permanent disability of 8.1% due to ischaemia were reported regarding arterial injuries following THR. With endovascular intervention techniques, the overall rate of amputations and persistent ischaemia has dropped significantly.

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