Arthroplasty Complications Clinical Trial
Official title:
Outcome of Total Hip Replacement in Patients With Chronic Renal Disease
the study aims to determine rate of mortality and morbidity after total hip replacement in patients with chronic kidney diseases and incidence of periprosthetic joint infection in these patients.
Retrospective review of the database of arthroplasty unit was conducted from January 2014 to
December 2018. Data of all patients who suffered from chronic kidney disease and underwent
hip arthroplasty because of fracture neck of femur or arthritis or head necrosis or any other
cause , will be collected as, Demographic characteristics: age , gender , place of residence
and diagnosis. Medical comorbidities: other comorbidities will be taken in consideration as
Diabetes, Hypertension and cardiac problems.
Detailed history of patient's renal disease: cause of renal disease ,duration of the renal
disease , grading of renal failure according to National Kidney Foundation (NKF) guidelines ,
medical treatment : whether the patient is on regular medical treatment or not, duration of
medical treatment and type of medications and dialysis history : whether the patient is
dialysis dependant or not, duration of being dialysis dependant and frequency of dialysis.
Post operative surgical complications as : dislocation, infection , periprosthetic fracture
or loosing and osteolysis.
Post operative medical complications as : myocardial infarction , stroke , pulmonary embolism
and deep venous thrombosis.
At Follow up :
Clinical assessment will be done for signs of infection as hotness , redness, tenderness and
discharge from wound site.
Functional assessment also will be done , it will be done by Harris Hip Score (HHS), Hip
Disability and Osteoarthritis Outcome Score (HOOS) and The 12-Item Short Form Survey (SF-12).
Radiological assessment also will be done for signs of loosing as lucency and component
migration and for signs of infection as periosteal reaction , irregular osteolysis , absence
of sclerotic border and cortical bone resorption .
Investigations for periprosthetic infection will be carried out: erythrocyte sedimentation
rate (ESR), C- reactive protein (CRP) and complete blood count (CBC) to predict presence of
infection , if they are positive , aspiration will be carried out to know type of organism.
If there is past definite history of infection, detailed data will be recorded as:
Time of presence of infection from surgery and result of culture and sensitivity ( if was
done) to know the type of the organism,type of treatment done(whatever medical or surgical
treatment) and frequency of infection recurrence.
Also history of revision surgery , rate and its causes will be recorded.
Those patients will be divided into two groups, one group is that group of chronic renal
disease patients who were on regular dialysis at time of operation and the other is that
group who were not dialysis dependant at time of operation . rate of each complication of the
previously mentioned complications, will be calculated in the two groups . Results will show
which group is at higher risk of complications of the two groups .
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