SELF-REPORTED COMPLICATION RATES FOLLOWING PRIMARY TOTAL HIP ARTHROPLASTY IN IRELAND – FACT OR FICTION?

Abstract

Currently, data on the complication rates of primary total hip arthroplasty (THA) in Ireland is not available. We surveyed all consultant members of the Irish Orthopaedic Association (IOA) to determine the self reported complication rates of primary THA and analysed national audit data from the Economic and Social Research Institute (ESRI) for 2002. We received an 83% response rate to our survey. 58 surgeons reported data on 5,424 primary THAs for the year 2003. The mean dislocation rate was 1.02% and those using a posterior approach reported a significantly higher dislocation rate (p< 0.05). Deep infection rates were 0.44% and 29% of these were MRSA infections. There was no significant benefit reported from the use of body exhaust operative attire. The mean rate of venous thrombo-embolism (VTE) was 3.5%. There was no statistical difference reported in VTE rates when prophylaxis was commenced pre or post operatively, neither was there any significant benefit reported from using VTE prophylaxis for an extended period beyond the length of inpatient stay, nor from patients wearing graduated compression elastic stockings. ESRI national audit rates for dislocation were 25.7%, and rates of deep infection and VTE were 0.87% and < 0.1% respectively in 2002. Deficiencies in available ESRI data and questionable reliability of self reported rates, underline the necessity for a national Hip Register database in Ireland. The accurate recording of objective data on primary THA could provide an evidence base to improve surgical THA practices and patient outcomes and provide significant healthcare savings.