Venous leg ulcers after hip replacement. A clinical evaluation at 5 to 12 years.

Venous ulceration is a chronic disabling complication of deep-vein thrombosis. The aim of this study was to estimate the incidence of venous leg ulcers five years or more after total hip replacement (THR) and to investigate some of the clinical features associated with their development. We carried out a postal survey of all patients who had undergone a THR 5 to 12 years previously. Replies from 816 patients showed that 66 (8.1%) had a history of leg ulcers. The prevalence of active ulceration was 2.6% and 43 patients (5.3%) reported developing ulceration since their hip replacement. A clinical review determined that 31 (3.8%) of these were true venous ulcers. The ulcers occurred more commonly on the operated side and developed at a mean of 5.8 years (18 months to 12 years) after the first arthroplasty. A mean of 1.9 arthroplasties (1 to 5) (primary and revision) were carried out before the ulcers appeared. The overall incidence of ulcers was similar to that in the general population.