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Occlusion of the common femoral artery by cement after total hip arthroplasty: a case report

DOI: 10.1186/1752-1947-3-86

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Abstract:

A 59-year-old Caucasian woman presented with rest pain, numbness and cramps in the operated limb after hip replacement. Cement leakage under the transverse ligament had caused occlusion of the common femoral artery necessitating vascular reconstruction. She had a good functional recovery at follow-up.To the best of our knowledge, this is the first well-documented case reporting this pathomechanism of vascular lesion to the femoral artery. This case report highlights the potential risk of such a limb-threatening complication, and awareness should lead to prevention by meticulous surgical technique (correct technique of pressurization) or to early detection of the lesion.Total hip arthroplasty (THA) is a successful procedure with a satisfactory outcome in patients with coxarthrosis. Vascular injuries are a rare complication after orthopedic surgery of the hip. The complication rate is reported to be approximately 0.2-0.3% [1-4]. The most commonly injured vessels are the external iliac artery and vein and the common femoral artery [5,6]. Vascular complications are usually caused by direct trauma due to an osteotome, retractor, screws or powered reamer [7]. Direct injury from cement has been reported due to intrapelvic wall penetration, with thermal injury to the external iliac artery causing occlusion by thrombosis [8-10].An unusual pattern of injury to the common femoral artery after THA is presented. Cement leakage under the transverse ligament caused occlusion of the common femoral artery necessitating vascular reconstruction.An obese 59-year-old Caucasian female patient with a history of symptomatic osteoarthritis of the left hip received an Exeter total hip arthroplasty (THA) (Stryker?) by the posterolateral approach. The acetabulum was prepared with several anchorage holes and low viscosity Simplex P (Stryker?) cement was pressurized. Cerclage wiring was used to control a trochanteric fissure. At that time, no further complications were noted. Postoperatively, th

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