The Journal of Arthroplasty
Volume 23, Issue 3 , Pages 360-365, April 2008

Postoperative Ileus After Total Joint Arthroplasty

  • Javad Parvizi, MD, FRCS

      Affiliations

    • Rothman Institute of Orthopedics at Thomas Jefferson Hospital, Seoul, South Korea
    • Corresponding Author InformationReprint requests: Javad Parvizi, MD, FRCs, 925 Chestnut Street, Philadelphia, PA 19107.
    • ,
  • Seung-Beom Han, MD

      Affiliations

    • Department of Orthopedic Surgery, Korea University, Seoul, South Korea
    • ,
  • T. David Tarity, BS

      Affiliations

    • Rothman Institute of Orthopedics at Thomas Jefferson Hospital, Seoul, South Korea
    • ,
  • Luis Pulido, MD

      Affiliations

    • Rothman Institute of Orthopedics at Thomas Jefferson Hospital, Seoul, South Korea
    • ,
  • Michael Weinstein, MD

      Affiliations

    • Department of Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania
    • ,
  • Richard H. Rothman, MD, PhD

      Affiliations

    • Rothman Institute of Orthopedics at Thomas Jefferson Hospital, Seoul, South Korea

Received 9 June 2007; accepted 30 December 2007.

Abstract 

We evaluated the incidence and risk factors for postoperative ileus (POI) after total joint arthroplasty in a consecutive group of patients between January 2004 and December 2005 using regional anesthesia and multimodal pain management protocols. Postoperative ileus developed in 31 (0.7%) of 4567 patients. Of these patients, 21 (67.7%) were men, and 10 (32.3%) were women, with a mean age of 68 years (range, 52-91 years). The ileus was treated successfully in 29 patients during the hospitalization. One patient died from this complication, and another one required sigmoid colon resection due to perforation. The risk factors for developing POI after joint arthroplasty were older age, male sex, hip arthroplasty, and prior history of abdominal surgery. The type and dose of narcotic medications, as administered using our current protocol, did not appear to influence the development of POI.

Key words: arthroplasty, replacement, hip, knee, intestinal pseudo-obstruction, ileus, opioid-related disorders, narcotics

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 These benefits or support were received from the following sources: Javad Parvizi, MD, received funding for his research from Stryker Orthopaedics. Richard H. Rothman is a consultant for Stryker Orthopaedics. Seung-Beom Han, David Tarity, Luis Pulido, and Michael Weinstein have nothing to disclose.

PII: S0883-5403(08)00007-7

doi:10.1016/j.arth.2007.12.019

The Journal of Arthroplasty
Volume 23, Issue 3 , Pages 360-365, April 2008

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