The Short-Term Complications Following Primary Total Hip Arthroplasty: A Retrospective Cohort Analysis in Iran

Background: Total hip arthroplasty (THA) is a highly effective yet resource-intensive procedure. Understanding local epidemiology of short-term complications is crucial for optimizing outcomes, especially in diverse populations where data may be limited. Objective: This study investigates the incidence and demographic associations of key short-term complications following primary THA in an Iranian tertiary referral center. Methods: A retrospective cohort study was conducted on ۹۲ consecutive patients who underwent primary THA at a major academic hospital in Tehran, Iran, between March ۲۰۱۹ and May ۲۰۲۴. The surgical approach was recorded, with the direct lateral approach being the most commonly used. Patient demographics, body mass index (BMI), surgical indication, and postoperative complications, specifically surgical site infection (SSI), prosthetic dislocation, venous thromboembolism (VTE), and leg length discrepancy (LLD), were extracted from medical records. Statistical analysis was performed using SPSS v۲۲, with significance set at p<۰.۰۵. Results: The mean age was ۴۹.۲ ± ۱۵.۲ years, and the mean BMI was ۲۵.۶ ± ۴.۳ kg/m². Osteoarthritis (۵۰.۰%) was the most common indication. Regarding surgical approach, ۲۴ patients (۲۶.۸%) underwent THA via an anterior approach, while ۶۸ patients (۷۳.۲%) underwent THA via a direct lateral approach. The incidence of complications was: SSI ۳.۳% (n=۳), dislocation ۵.۴% (n=۵), and VTE ۱.۱% (n=۱). All SSI cases occurred in male patients. Dislocation rates were numerically higher in patients under ۵۰ years (۸.۰% vs. ۲.۴%, p=۰.۳۷) and in females (۹.۳% vs. ۲.۰%, p=۰.۱۷). The single VTE case occurred in an obese (BMI>۳۰) female. No statistically significant association was found between BMI categories and complication rates. Mean LLD was ۹.۷ ± ۵.۷ mm, with no significant variation across demographic groups. Conclusion: In this small cohort, SSI and VTE rates were within internationally reported ranges. The dislocation rate (۵.۴%) was elevated despite the predominant use of the direct lateral approach, suggesting that factors beyond surgical approach, such as implant selection or patient-specific variables, may contribute to instability in this population. Larger, multicenter studies are needed to determine complication rates and risk factors accurately.

کلیدواژه ها:

Total hip arthroplasty ، Short-term complications ، Dislocation ، Surgical Site Infection ، Venous thromboembolism