Intrapelvic complications after total hip arthroplasty failure.
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.
Bach
Christian Michael
CM
Department of Orthopaedic Surgery, University of Innsbruck, Anichstrasse 35, A-6020 Innsbruck, Austria. christian.bach@uibk.ac.at
Steingruber
Iris Eva
IE
Ogon
Michael
M
Maurer
Herbert
H
Nogler
Michael
M
Wimmer
Cornelius
C
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