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Fistula between a total hip arthroplasty and the rectum: a case report
Clinical Orthopaedics and Related Research
|July 14, 2001
Summary
A rare rectal fistula connected to a hip replacement infection, a previously unreported complication of total hip arthroplasty, was diagnosed in an 81-year-old man.
Area of Science:
- Gastroenterology and Orthopedic Surgery
- Infectious Diseases
Background:
- Total hip arthroplasty (THA) is a common orthopedic procedure.
- Complications of THA can include infection and loosening, but fistulous connections to the gastrointestinal tract are exceptionally rare.
Observation:
- An 81-year-old male presented with a draining sinus tract in the terminal rectum.
- Radiographs showed a failed, migrated total hip arthroplasty within the pelvis.
- Hip aspiration identified bacteria consistent with gastrointestinal flora.
Findings:
- A fistulogram confirmed a direct connection between the rectum and the infected hip prosthesis.
- This represents a previously unreported complication of total hip arthroplasty: a colo-acetabular fistula.
Implications:
- This case highlights an extremely uncommon but severe complication of THA.
- Early recognition and diagnosis are crucial for managing such complex infections.
- Further investigation into risk factors and management strategies for this rare fistula is warranted.