External iliac artery injury complicating prosthetic hip resection for infection

Vascular injury is a rare but devastating complication of total hip arthroplasty. We present 2 cases of external iliac artery injury that complicated the removal of a chronically infected total hip arthroplasty where the acetabular component had migrated medial to Kohler's line. In both cases, hemostasis and reperfusion were achieved with the assistance of a vascular surgeon. This report describes the diagnosis, treatment, and associated risk factors for this rare complication. The combination of deep infection and medial migration of the acetabular component represents a high-risk situation for vascular injury. We advocate preoperative consultation with a vascular surgeon in this setting.