Razavi Journal of Medicine

Razavi Journal of Medicine

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

Articles in Press

Document Type : Original Article

Authors
Karim Pisoudeh 1, 2
Hamidreza Dehghani Nazhvani 1, 2
Omid Elahifar 1, 2
Jaber Kazemi 1, 2
Ali Tashakor 1, 2
1 Bone and Joint reconstruction research center, Shafa Orthopedic Hospital, Iran University of Medical Sciences, Tehran, Iran
2 Department of Orthopedics, School of Medicine, Bone and Joint Reconstruction Research Center, Firoozgar General Hospital, Iran University of Medical Sciences, Tehran, Iran
10.30483/rjm.2026.254713.1477
Abstract
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 92 consecutive patients who underwent primary THA at a major academic hospital in Tehran, Iran, between March 2019 and May 2024. 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 v22, with significance set at p<0.05.
 
Results: The mean age was 49.2 ± 15.2 years, and the mean BMI was 25.6 ± 4.3 kg/m². Osteoarthritis (50.0%) was the most common indication. Regarding surgical approach, 24 patients (26.8%) underwent THA via an anterior approach, while 68 patients (73.2%) underwent THA via a direct lateral approach. The incidence of complications was: SSI 3.3% (n=3), dislocation 5.4% (n=5), and VTE 1.1% (n=1). All SSI cases occurred in male patients. Dislocation rates were numerically higher in patients under 50 years (8.0% vs. 2.4%, p=0.37) and in females (9.3% vs. 2.0%, p=0.17). The single VTE case occurred in an obese (BMI>30) female. No statistically significant association was found between BMI categories and complication rates. Mean LLD was 9.7 ± 5.7 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 (5.4%) 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.
Keywords
Total hip arthroplasty
Short-term complications
Dislocation
Surgical site infection
Venous thromboembolism

Acknowledgements: This article was extracted from a thesis submitted by the author (code of ethics:( IR.IUMS.FMD.REC.1404.143). In this manner, gratitude and acknowledgment are extended to all the individuals who participated in the research and provided assistance.

 

Availability of data and materials: The study provides access to the dataset upon request from the corresponding author.

 

Conflicts of interests: The authors declare that they have no competing interests.

 

Consent for publication: Not applicable.

 

Ethics approval and consent to participate: This study was approved by the ethical committee of the Iran University of Medical Sciences under the approval code IR.IUMS.FMD.REC.1404.143 Written informed consent for publication of their clinical details and clinical images was obtained from the patient.

 

Financial disclosure: No financial support was received for this study.

 

Author contributions: K.P: Contributed to the conception and design of the study, data acquisition, drafting the manuscript, supervision and approving the final version of the manuscript. H.D.N: Contributed to the data analysis and interpretation, statistical analysis, drafting the manuscript, and approving the final version.  O.E: critical revision of the manuscript, and approval of the final version. J.K: literature review, drafting the methodology section, and approving the final version. A. T: Contributed to the conception and design of the work, data interpretation, drafting the manuscript, critical revision of the manuscript, and approval of the final version.

 

 

Open Access Policy: This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. To view a copy of this licence, visit https://creativecommons.org/licenses/by/4.0/

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Razavi Journal of Medicine

Articles in Press, Accepted Manuscript
Available Online from 15 March 2026