[Complications after total hip replacement (author's transl)]

Abstract

Alloarthroplastic replacement of the hip comprises certain risks. Therefore good apparative and instrumental equipment and biological understanding of the post operative phase are necessary. Our rate of operative complications was 1.3% of all cases. In this number fat embolism after implantation of acrylic cement is of special interest. Reference is made of animal experiments on the pathogenesis of this phenomenon. Early complications comprise luxation of the prosthesis, bleeding and hematoma formation, iliotibial-nerve syndrome, phlebothrombosis, embolism, early infection. Late complications comprise infection and loosening of the prosthesis. In a total of 1200 implantations we had early complications in 1.8% and late complications in 0.9%. Reference is made of clinical and X-ray signs of loosening of the implant. Arthrography proved to be the most dependable method. We found periarticular calcifications in 30% of all cases. Fractures of the prosthesis were extremely rare: in few cases we found fractures of the polyestercup. In all cases the aggressive granuloma will leed to rarefication of bone sooner or later going along with loosening of the implant.