INTRODUCTION: Arterial injuries due to total hip arthroplasty can be a serious complication. The risk of vascular injury is related to proximity of the structures, tractions, and the aggressive use of instruments. OBJECTIVES: To analyze the frequency, injury mechanism, clinical presentation and therapeutic options in this kind of injury. PATIENTS AND METHOD: A group of 4162 patients subjected to total hip arthroplasty between 1986 and 2006 (reinterventions 7.2%). We describe 8 cases (5 women and 3 men) with a mean age of 61 years (reinterventions 50%). The vascular surgery was performed at less than 1 hour (n = 4), 6 hours (n = 2), 16 hours (n = 1) and 20 days (n = 1). RESULTS: The most frequent locations were external iliac artery (n = 3), common femoral (n = 3), internal iliac (n = 1) and deep femoral (n = 1). The clinical presentation was, internal bleeding (50%), acute limb ischemia (37%) and subacute limb ischemia (13%). The surgical interventions were bypass (50%), arteriorrhaphy (25%), primary repair (12.5%), and thrombectomy and patching (12.5%). One case was reoperated 6 years later, as we found a false anastomotic aneurism in a previous ilio-femoral bypass. The death and amputation rates were 0%. CONCLUSIONS: Although these injuries are rare, they involve a life-threatening complication. The external iliac artery/common femoral artery are the most frequent location. Most patients required a bypass, although the surgical technique depends on the injury location.
INTRODUCTION: Arterial injuries due to total hip arthroplasty can be a serious complication. The risk of vascular injury is related to proximity of the structures, tractions, and the aggressive use of instruments. OBJECTIVES: To analyze the frequency, injury mechanism, clinical presentation and therapeutic options in this kind of injury. PATIENTS AND METHOD: A group of 4162 patients subjected to total hip arthroplasty between 1986 and 2006 (reinterventions 7.2%). We describe 8 cases (5 women and 3 men) with a mean age of 61 years (reinterventions 50%). The vascular surgery was performed at less than 1 hour (n = 4), 6 hours (n = 2), 16 hours (n = 1) and 20 days (n = 1). RESULTS: The most frequent locations were external iliac artery (n = 3), common femoral (n = 3), internal iliac (n = 1) and deep femoral (n = 1). The clinical presentation was, internal bleeding (50%), acute limb ischemia (37%) and subacute limb ischemia (13%). The surgical interventions were bypass (50%), arteriorrhaphy (25%), primary repair (12.5%), and thrombectomy and patching (12.5%). One case was reoperated 6 years later, as we found a false anastomotic aneurism in a previous ilio-femoral bypass. The death and amputation rates were 0%. CONCLUSIONS: Although these injuries are rare, they involve a life-threatening complication. The external iliac artery/common femoral artery are the most frequent location. Most patients required a bypass, although the surgical technique depends on the injury location.