Acute Arterial Ischemia Secondary to Intrapelvic Acetabular Migration: A Multidisciplinary Approach.

Area of Science:

• Orthopedic Surgery
• Vascular Surgery
• Emergency Medicine

Background:

• Intrapelvic acetabular migration of hip prostheses is a rare complication.
• Acute limb ischemia (ALI) following hip arthroplasty is a serious, limb-threatening event.
• Delayed surgical correction of prior traumatic events may increase risk.

Observation:

• A 67-year-old female presented with ALI 72 hours post-trauma, with displaced hip prosthesis causing external iliac artery compression.
• Preoperative assessment by a multidisciplinary team diagnosed SVS III irreversible ALI.
• The patient had a history of refusing recommended surgical correction for a previous traumatic event.

Findings:

• Emergency hip disarticulation and mechanical thrombectomy of the external iliac artery were performed.
• Successful restoration of iliac pulse and significant postoperative pain relief were achieved.
• The patient demonstrated improved mental status post-intervention.

Implications:

• Early diagnosis and management of acute arterial injury are critical for preventing severe outcomes.
• Vigilant monitoring during hip replacements and a multidisciplinary approach are essential for complex cases.
• Further research is needed to refine diagnostic and therapeutic strategies for this rare complication.