Extensive skin necrosis following total hip arthroplasty performed through the direct anterior approach

BMC Musculoskeletal Disorders

Case Report

Nimatullah Idris¹  Morgan Gauthier¹  Didier Hannouche¹  Matthieu Zingg¹  Daniel F. Kalbermatten²  Carlo M. Oranges² 

[1] Department of Orthopaedic Surgery, Geneva University Hospitals & Faculty of Medicine, Avenue Gabrielle Perret Gentil 4, 1205, Geneva, Switzerland;Department of Plastic, Reconstructive and Aesthetic Surgery, Geneva University Hospitals & Faculty of Medicine, Geneva, Switzerland;

关键词: Total hip arthroplasty (THA);    Skin necrosis;    Wound complication;    Periarticular infiltration (PAI);    Anterolateral thigh flap;   

DOI  :  10.1186/s12891-023-06643-z

 received in 2023-01-25, accepted in 2023-06-16,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundTotal hip arthroplasty is a widely performed surgical procedure, which enables patients to regain mobility, alleviates pain, and improves overall quality of life. Periarticular multimodal drug infiltration (PAI) is increasingly being used as an effective postoperative pain management, decreasing the systemic consumption of opioids. Extensive postoperative skin necrosis without a deep joint infection as a complication of total hip arthroplasty with PAI has not yet been described.Case presentationA 71-year-old patient who underwent total hip arthroplasty of the right hip for primary osteoarthritis through the Direct Anterior Approach presented postoperatively a large area of necrotic skin at the incision. Joint infection was excluded. An extensive debridement was performed and the tissue defect was reconstructed by a pedicled anterolateral thigh flap. The skin maintained a satisfactory appearance at 1 year postoperatively, and the hip was pain-free with restored ranges of motion. The patient was able to walk with no support and without limitation.ConclusionWe address the possible risk factors, discuss the use of epinephrine in PAI and explore possible treatment options for such a complication.

【 授权许可】

CC BY   
© The Author(s) 2023

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