Intrapelvic complications after total hip arthroplasty failure

Area of Science:

• Orthopedic Surgery
• Pelvic Anatomy
• Medical Device Failure

Background:

• Severe total hip arthroplasty (THA) failure with central prosthetic component migration is rare.
• Perforation of the medial acetabular wall during THA failure can injure intrapelvic structures.
• Understanding these risks is crucial for managing complex THA revisions.

Purpose of the Study:

• To review the incidence and nature of intrapelvic injuries associated with centrally migrated THA components.
• To elucidate the anatomical proximity of critical intrapelvic structures to dislocated prosthetic cups.
• To inform clinical practice regarding the potential complications of failed hip replacements.

Main Methods:

• A meta-analysis of English literature was conducted to identify cases of intrapelvic injury.
• A human pelvic cadaver model was utilized to demonstrate anatomical relationships.
• The study analyzed reported complications and involved structures.

Main Results:

• Fifty cases of intrapelvic injury secondary to THA failure were identified.
• The external iliac artery and bladder were the most frequently injured structures.
• Common complications included fistula formation, false aneurysms, and hemorrhage.

Conclusions:

• Failed total hip replacements with central component migration pose a significant risk of damage to pelvic viscera.
• Awareness of these potential injuries is essential for orthopedic surgeons.
• Prompt recognition and management are critical for favorable patient outcomes.