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Chronic expanding hematomas arising over a decade post primary total hip arthroplasty
Chuanlong Wu1, Hongyi Wang1, Teng Yu2
1Department of Orthopaedics, Shanghai Key Laboratory for Prevention and Treatment of Bone and Joint Diseases, Shanghai Institute of Traumatology and Orthopaedics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Chronic expanding hematoma (CEH) after total hip arthroplasty (THA) is rare but serious. Early diagnosis and surgical resection are crucial for managing this complication and preventing severe outcomes.
Area of Science:
- Orthopedic Surgery
- Radiology
- Pathology
Background:
- Chronic expanding hematoma (CEH) is a rare complication following total hip arthroplasty (THA).
- Mismanagement can lead to severe consequences, necessitating a thorough understanding of its diagnosis and treatment.
- This study addresses the infrequent yet serious nature of CEH post-THA.
Purpose of the Study:
- To retrospectively analyze patients who developed CEH after THA.
- To review existing literature on CEH following THA.
- To provide clinical insights into CEH diagnosis and management.
Main Methods:
- Retrospective analysis of patients undergoing THA over 20 years with subsequent CEH development.
- Collection of patient demographics, implant details, and imaging studies.
- Comprehensive literature review of reported CEH cases post-THA.
Main Results:
- Five patients developed CEH post-THA, with varied outcomes after revision surgery, including recurrence, amputation, and periprosthetic joint infection (PJI).
- Literature review identified nine similar cases.
- MRI findings include mixed T1/T2 signals; histology shows fibrous encapsulation, blood clots, and connective tissue.
Conclusions:
- CEH after THA is a rare, slow-progressing complication requiring vigilant follow-up.
- Timely identification and prompt treatment, typically surgical resection, are essential for optimal outcomes.
- This research aims to improve diagnostic accuracy, treatment strategies, and patient prognosis for CEH post-THA.
