Femoral nerve palsy in hip replacement due to pelvic cement extrusion

We report a case in which cement protrusion into the pelvis led to a major complication. During reaming and preparation of the anterosuperior acetabulum, a bony defect resulted which made fixation of an uncemented cup impossible, and a cemented polyethylene cup was used instead. After surgery the patient suffered a complete loss of femoral nerve function. Postoperative X-rays and CTs showed that a huge mass of bone cement protruded into the pelvis in close proximity to the iliac vessels and the femoral nerve. This probably led to nerve damage during the cement's polymerisation process due to the heat.