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Related Experiment Videos

Complications after total hip replacement. The contralateral limb.

J W Smith1, P M Pellicci, N Sharrock

  • 1Hospital for Special Surgery, New York City, N.Y. 10021.

The Journal of Bone and Joint Surgery. American Volume
|April 1, 1989
PubMed
Summary
This summary is machine-generated.

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Intraoperative pressure on the groin during hip surgery can cause serious contralateral limb complications. Monitoring and specific techniques can help minimize these risks in patients undergoing hip replacement.

Area of Science:

  • Orthopedic Surgery
  • Vascular Surgery
  • Nephrology

Background:

  • Total hip replacement and trochanteric osteotomy are common orthopedic procedures.
  • The lateral decubitus position is frequently used for hip surgeries.
  • Contralateral limb complications following these procedures are rare but severe.

Observation:

  • Six patients experienced complications on the non-operative side, including nerve issues, severe thigh swelling with muscle death, acute kidney injury from myoglobinuria, and limb-threatening arterial insufficiency.
  • Intraoperative monitoring of external pressure in the contralateral femoral triangle and blood flow to the contralateral foot was performed in seventeen patients.

Findings:

  • Increased intraoperative pressure at the groin was confirmed, supporting its role in causing vascular compromise.

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  • Potential contributing factors include pre-existing vascular disease, obesity, patient positioning, and hypotensive anesthesia.
  • Several techniques were identified to mitigate contralateral limb complications during hip operations.

    • Implications:

    • Understanding the mechanisms of contralateral limb injury is crucial for patient safety.
    • Implementing preventative strategies can reduce the incidence of severe complications like amputation and organ failure.
    • Further research into optimal patient positioning and intraoperative pressure management is warranted.