Disseminated intravascular coagulopathy in a patient undergoing total hip arthroplasty for carcinoma. A case report.

A 78-year-old man was treated by total hip arthroplasty (THA) for metastatic carcinoma of the proximal femur. After operation, disseminated intravascular coagulopathy (DIC) developed. DIC is a known complication of malignancy but is reported infrequently as a complication of THA. Its occurrence in this patient may have been triggered by the release of coagulant proteins from surgical manipulation of the tumor. The disorder was characterized clinically by profuse uncontrollable hemorrhage from the surgical wound. Laboratory abnormalities indicated a consumptive coagulopathy. Guidelines for the diagnosis and management of a patient with DIC are available. Orthopedic surgeons should be alerted to the potential of this serious complication in patients treated by THA for metastatic bone abscess of the hip.