[Arterial false aneurysm after total hip arthroplasty. A case report]

Vessel damage during implantation of a total hip arthroplasty is exceptional (0.2-0.3% incidence). We observed a case of false aneurysm of the common femoral artery diagnosed in a pauci-symptomatic patient seven months after total hip arthroplasty. The vessel was damaged by a fragment of cement in contact with the artery. Treatment consisted in extraction of the cement fragment and insertion of a vascular prosthesis after dissection and ligature of the pseudoaneurysm. A review of the literature of vascular complications after prosthetic hip surgery was undertaken. Early complications include acute bleeding or ischemia while late complications include pseudoaneurysm or arteriovenous fistulization. Predisposing factors are: infection, repeated contact between the implants and arterial walls, overly medial reaming of the acetabulum, intrapelvic cement spikes, and use of Hohmann retractor. We detail here the clinical signs, diagnostic approach, and natural course of arterial false aneurysm resulting from intra-pelvic cement leakage.