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Clinical Orthopaedics and Related Research®
Published in: Clinical Orthopaedics and Related Research® 2/2016

01-02-2016 | Symposium: 2015 Hip Society Proceeding

Complications of Total Hip Arthroplasty: Standardized List, Definitions, and Stratification Developed by The Hip Society

Authors: William L. Healy, MD, Richard Iorio, MD, Andrew J. Clair, MD, Vincent D. Pellegrini, MD, Craig J. Della Valle, MD, Keith R. Berend, MD

Published in: Clinical Orthopaedics and Related Research® | Issue 2/2016

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Abstract

Background

Reporting of complications after total hip arthroplasty (THA) is not standardized, and it is done inconsistently across various studies on the topic. Advantages of standardizing complications include improved patient safety and outcomes and better reporting in comparative studies.

Questions/purposes

The purpose of this project was to develop a standardized list of complications and adverse events associated with THA, develop standardized definitions for each complication, and stratify the complications. A further purpose was to validate these standardized THA complications.

Methods

The Hip Society THA Complications Workgroup proposed a list of THA complications, definitions for each complication, and a stratification scheme for the complications. The stratification system was developed from a previously validated grading system for complications of hip preservation surgery. The proposed complications, definitions, and stratification were validated with an expert opinion survey of members of The Hip Society, a case study evaluation, and analysis of a large administrative hospital system database with a focus on readmissions.

Results

One hundred five clinical members (100%) of The Hip Society responded to the THA complications survey. Initially, 21 THA complications were proposed. The validation process reduced the 21 proposed complications to 19 THA complications with definitions and stratification that were endorsed by The Hip Society (bleeding, wound complication, thromboembolic disease, neural deficit, vascular injury, dislocation/instability, periprosthetic fracture, abductor muscle disruption, deep periprosthetic joint infection, heterotopic ossification, bearing surface wear, osteolysis, implant loosening, cup-liner dissociation, implant fracture, reoperation, revision, readmission, death).

Conclusions

Acceptance and use of these standardized, stratified, and validated THA complications and adverse events could advance reporting of outcomes of THA and improve assessment of THA by clinical investigators.

Level of Evidence

Level V, therapeutic study.
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Metadata
Title
Complications of Total Hip Arthroplasty: Standardized List, Definitions, and Stratification Developed by The Hip Society
Authors
William L. Healy, MD
Richard Iorio, MD
Andrew J. Clair, MD
Vincent D. Pellegrini, MD
Craig J. Della Valle, MD
Keith R. Berend, MD
Publication date
01-02-2016
Publisher
Springer US
Published in
Clinical Orthopaedics and Related Research® / Issue 2/2016
Print ISSN: 0009-921X
Electronic ISSN: 1528-1132
DOI
https://doi.org/10.1007/s11999-015-4341-7

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