Incidence of spinal-epidural haematoma after neuraxial anaesthesia for total hip and knee arthroplasty: a single-centre analysis of 96 103 consecutive cases from 2013 to 2023
Authors' conclusion
We found a low incidence of EH following total joint arthroplasty performed under neuraxial anaesthesia. Although spinal anaesthesia was performed almost four times more frequently, EH was exclusively associated with epidural techniques.
Study context
- Population
- Patients undergoing primary unilateral or bilateral total hip or knee arthroplasty under neuraxial anaesthesia, January 2013 to December 2023
- Participants
- 96,103 consecutive cases
- Exposure
- Epidural or CSE vs spinal anaesthesia
- Epidural or CSEn = 20,898
- Spinaln = 75,205reference
- Outcome
- Frequency of epidural haematoma (EH) by primary anaesthetic type
Methodological detailssingle-centre, consecutive patients
- Single-centre
- Consecutive patients
Main finding
As reported in the abstract
Frequency of EH
Spinal
0:75 000
0 of 75 205
Epidural or CSE
1:10 000
95% CI 0.1-3.5:10 000
- One symptomatic epidural haematoma (EH) after total hip arthroplasty under CSE, requiring urgent lumbar decompression with EH evacuation
- 1
- One asymptomatic EH after epidural anaesthesia, managed conservatively
- 1
Observational data: associations, not effects.
Original publication
Incidence of spinal-epidural haematoma after neuraxial anaesthesia for total hip and knee arthroplasty: a single-centre analysis of 96 103 consecutive cases from 2013 to 2023. Br J Anaesth. Published 18 May 2026. doi:10.
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