**Author details**

**3.3. Postoperative management**

154 Total Hip Replacement - An Overview

**4. Conclusion**

**Acknowledgements**

**Conflict of interest**

vascular injury is determined by diagnosis [13, 19].

of these injuries rather than its management.

The authors declare no conflict of interest.

Postoperative insult of vessel injury by surgeons, which is the slightly lesser common cause of unexplained pathological complications, might even result in death. Immediate after surgery to few days of recovery, careful monitoring of vessel status is essential to avoid postoperative vessel complications. After surgery and in the late postoperative period there are many sign and symptoms, the surgeons, and even individual must not circumvent, of course, it may be the sign of late vascular injury. Unexplained hypotension, tachycardia, nerve palsy, hypovolemic shock and decreased hemoglobin and blood pressure are the signs of vascular injury, postoperatively. In postoperative cases with the above signs and symptoms, immediate axial imaging or radiography, contrast-angiography, color ultrasonography are the more natural way to diagnose the bleeding source. Monitoring of these signs wisely is better and can be treated with open repair, stenting, bypass, coiling, or chemoembolization without any delay (**Figure 7**) [37–39]. The late symptoms from false aneurysm formation might be in the broad range of spectrum and very confusing and can be treated by surgical intervention, once the

Total hip replacement surgery is largely performed in aged patients and possibility of arteriosclerosis vessel must be taken into account, as these vessels are more vulnerable to injury [29].

Conclusively, vascular injuries are rare in hip replacement surgeries. Careful preoperative planning, better instrumentation, knowledge of anatomical structures and meticulous surgical technique are necessary to avoid vascular injury. In advent screw penetration leading to vascular injuries can present early as hemorrhage during surgery, in the intermediate term as postoperative bleeding, hypotension, etc., and late as pseudoaneurysms. Further, management of these complications is beyond the scope of this chapter which focuses on prevention

The authors would thank Professor P.P. Bansod, Head of Department, Department of Biomedical Engineering, SGSITS, Indore, India, for facilitating in preparation of this chapter.

Nishant Kumar Singh1 , Sanjay Rai2 \* and Amit Rastogi3

\*Address all correspondence to: skrai.bme@iitbhu.ac.in

1 Department of Biomedical Engineering, National Institute of Technology, Raipur, India

2 Biomechanics Lab, School of Biomedical Engineering, Indian Institute of Technology, Banaras Hindu University, Varanasi, India

3 Department of Orthopedics, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India
