Femoral artery and nerve compression by bulk allograft used for acetabular reconstruction. An unreported complication

Absent pulses in the ipsilateral limb and a femoral nerve palsy occurred after revision total hip arthroplasty. Emergent arteriogram revealed an occlusion of the femoral artery inferior to the inguinal ligament. The femoral artery was found to be compressed by the bulk allograft bone used for reconstruction of an anterior segmental acetabular defect. No laceration or thrombosis of the artery was present. A high-speed burr was used to remove the anterior portion of the offending allograft. Pulses were immediately restored and the patient had no long-term vascular sequelae. The femoral nerve palsy has slowly resolved over 2 years.