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[Arterial vascular lesions after total hip joint replacement]
A Schätzler1, P Heilberger, M Möllers
1Klinik für Unfallchirurgle, Klinikum Nürnberg Süd.
Der Unfallchirurg
|July 1, 1997
Summary
Total hip replacement can lead to external iliac artery thrombosis due to component issues. Angiography is recommended for acute limb ischemia, with extra-anatomic bypasses preferred over thrombectomies for treatment.
Area of Science:
- Vascular Surgery
- Orthopedic Surgery
- Medical Device Complications
Background:
- Total hip replacement (THR) is a common orthopedic procedure.
- Complications involving major blood vessels are rare but serious.
- External iliac artery (EIA) thrombosis is a potential, though infrequent, complication.
Observation:
- Three cases of EIA thrombosis following THR are presented.
- Thrombosis was linked to acetabular component protrusion or cement/spongiosa impaction.
- One case of intraoperative arterial injury during revision THR is also described.
Findings:
- Compression of iliac vessels by prosthetic components or bone cement can cause thrombosis.
- Acute ischemic syndromes in lower limbs post-THR warrant investigation for extravascular compression.
- Angiography is crucial for diagnosing these vascular complications.
Implications:
- Early diagnosis via angiography can identify extravascular causes of thrombosis.
- Extra-anatomic bypass grafting is recommended as the preferred surgical treatment.
- Thrombectomy may be less effective than bypass for managing post-THR EIA thrombosis.