VENOUS LEG ULCERS AFTER TOTAL HIP REPLACEMENT: A CLINICAL EVALUATION AT 5–12 YEARS

Abstract

Venous ulceration is a chronic disabling complication of deep vein thrombosis. The aim of this study is to estimate the incidence of venous leg ulcers five years or more after total hip replacement, and to investigate some of the clinical features associated with the development of the ulcers. A postal survey of all the patients who had received a total hip replacement 5–12 years previously was done.

Replies from 816 patients yielded 66 patients [8.1.%] with a history of leg ulcers. Prevalence of active ulceration was 2.6%. 43 patients [5.3%] reported ulceration since their hip replacement. A clinical review determined that 31 [3.8%] of these were true venous ulcers. The ulcers occurred with a higher frequency on the operated side, appearing at a mean of 5.8 years after the first lower limb arthroplasty [range 18 months to 12 years]. An average of 1.9 arthroplasties [primary and revision] were carried out prior to the ulcers appearing [max 5, min 1]. Our findings suggest that although the overall incidence rate of leg ulcers was similar to that reported in the general population, we found a tendency for the ulcers to occur on the operated rather than the unoperated leg.