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

Abstract

Introduction: The incidence of vascular injuries after total hip arthroplasty is extremely low. In this report we describe an unusual injury to the common femoral artery.

Case presentation: 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.

Conclusion: 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.

Figure 1

Anteroposterior radiograph showing the cemented total hip prosthesis with no obvious cement extrusion in the pelvis or soft tissue.

Figure 2

Lesion of the posterior aspect of the common femoral artery due to cement.

Figure 3

Reconstruction of the cement leakage under the transverse ligament.

Figure 4

The unique print of the cemented acetabular cup on the extracted cement mass clearly demonstrates the pathomechanism of leakage under the transverse ligament.