title: Intrapelvic complications after total hip arthroplasty failure.
abstract: BACKGROUND
  Severe total hip arthroplasty failure with central migration of prosthetic components is uncommon. If perforation of the medial acetabular wall occurs, injuries of intrapelvic structures may result.
  
  
  METHODS
  A meta-analysis of the English literature was performed. A human pelvic cadaver was used to demonstrate the proximity of intrapelvic structures to a centrally dislocated cup.
  
  
  RESULTS
  Fifty cases of intrapelvic injury were identified. Structures involved most frequently were the external iliac artery and the bladder. The most common types of complication included fistula formation, development of a false aneurysm, and hemorrhage. The human cadaver pelvis demonstrated the proximity of intrapelvic vessels, the bladder, the ureter, the vagina, the deferent duct, the sigmoid colon, the rectum, and the sciatic nerve to an intrapelvically intruded prosthesis.
  
  
  CONCLUSIONS
  Failed total hip replacements should be considered to cause damage to pelvic viscera.
authors.affiliation: Department of Orthopaedic Surgery, University of Innsbruck, Anichstrasse 35, A-6020 Innsbruck, Austria. christian.bach@uibk.ac.at
authors.forename: Christian Michael
authors.initials: CM
authors.lastname: Bach
authors.forename: Iris Eva
authors.initials: IE
authors.lastname: Steingruber
authors.forename: Michael
authors.initials: M
authors.lastname: Ogon
authors.forename: Herbert
authors.initials: H
authors.lastname: Maurer
authors.forename: Michael
authors.initials: M
authors.lastname: Nogler
authors.forename: Cornelius
authors.initials: C
authors.lastname: Wimmer
mesh_terms: D017541:Aneurysm, False / Q000209:etiology; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects*; D002102:Cadaver; D016154:Digestive System Fistula / Q000209:etiology; D005548:Foreign-Body Migration; D006471:Gastrointestinal Hemorrhage / Q000209:etiology; D006801:Humans; D010388:Pelvis / Q000293:injuries* / Q000473:pathology; D011183:Postoperative Complications; D011475:Prosthesis Failure