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[A swollen leg after total hip arthroplasty]
D S Kuiken1, B L E F ten Have, J J A M van Raay
1Martini Ziekenhuis, locatie van Swieten, afd. Orthopedie, Postbus 30.033, 9700 RM Groningen.
Nederlands Tijdschrift Voor Geneeskunde
|November 13, 2008
Summary
Cystic enlargement of the iliopectineal bursa after total hip arthroplasty can cause leg swelling by obstructing the femoral vein. Surgical removal of the bursa resolved symptoms in two patients.
Area of Science:
- Orthopedic Surgery
- Vascular Surgery
- Pathology
Background:
- Total hip arthroplasty (THA) is a common procedure for hip joint replacement.
- Complications of THA can include issues related to prosthetic wear and surrounding soft tissues.
- Iatrogenic venous obstruction is a rare but significant complication.
Observation:
- Two female patients presented with unilateral leg swelling, pain, and gait disturbance post-THA.
- Clinical examination and investigations revealed cystic enlargement of the iliopectineal bursa compressing the femoral vein.
- Pathological analysis identified foreign body giant cells, polyethylene debris, and metal pigments within the bursa.
Findings:
- Cystic iliopectineal bursitis causing venous obstruction is an uncommon complication of THA.
- The bursal enlargement was attributed to polyethylene wear debris from the hip prosthesis.
- Surgical excision of the enlarged bursa led to rapid patient recovery.
Implications:
- This case highlights an unusual cause of unilateral leg swelling following THA.
- Early diagnosis and surgical intervention are crucial for managing this complication.
- Addressing polyethylene wear in THA implants may help prevent such occurrences.
