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Related Experiment Video

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The Transition to an Anterior-Based Muscle Sparing Approach Improves Early Postoperative Function but is Associated with a Learning Curve

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Bladder tear during revision total hip arthroplasty.

Jonathan N Grauer¹, Andrea Halim, Kristaps J Keggi

¹Department of Orthopaedics and Rehabilitation, Yale University School of Medicine, New Haven, CT. jonathan.grauer@yale.edu.

American Journal of Orthopedics (Belle Mead, N.J.)

|August 20, 2014

Summary

Revision total hip arthroplasty can rarely cause bladder tears due to adhesions. Early recognition of hematuria is key for successful treatment of this rare intrapelvic complication.

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Area of Science:

Orthopedic Surgery
Urology
Surgical Complications

Background:

Total hip arthroplasty (THA) and revision THA are common orthopedic procedures.
Intrapelvic complications, including bladder injuries, are rare but serious risks.
Previous bladder injuries in THA have involved thermal necrosis, component migration, or direct perforation.

Observation:

This report details an unusual case of intraoperative bladder tear during revision THA.
The patient's history of multiple prior hip surgeries likely caused pelvic adhesions, predisposing the bladder to injury.
This specific mechanism of bladder tear due to adhesions during revision THA has not been previously reported.

Findings:

The bladder tear occurred intraoperatively during acetabular revision in a patient with prior hip surgeries.
Recognition of hematuria, both intraoperatively and postoperatively, was crucial for diagnosis.
The patient received appropriate treatment and experienced an acceptable outcome.

Implications:

Highlights the importance of surgeon awareness regarding rare intrapelvic complications during revision THA.
Suggests that pre-existing adhesions in patients with multiple prior hip surgeries may increase the risk of bladder injury.
Emphasizes the need for prompt diagnosis and management of hematuria following hip arthroplasty procedures.