A late vascular complication due to component migration after revision total hip arthroplasty.
Although vascular injuries associated with primary and revision total hip arthroplasty are infrequent, these complications can have devastating effects that can lead to morbidity and even mortality. No previous reports have described embolic distal limb ischemia secondary to a failed and migrated acetabular implant in discontinuity with the pelvis. We present a novel case in which a screw from a failed and migrated acetabular cage construct led to injury of the superficial femoral artery. While awaiting the construction of a custom prosthesis, the patient developed thromboembolism leading to distal extremity ischemia. The patient was treated with thrombolytic therapy, anticoagulation, removal of the offending hardware, forefoot amputation, and later hip reconstruction. Recognition of the risks associated with failed and migrated components may prevent this complication in the future.
Hussain
Waqas M
WM
Department of Surgery, Section of Orthopaedic Surgery and Rehabilitation, University of Chicago Medical Center, Chicago, IL 60637, USA.
Hussain
Haroon M
HM
Hussain
Mohammed S
MS
Manning
David W
DW
D000671:Amputation, Surgical; D001168:Arthritis / Q000601:surgery; D019644:Arthroplasty, Replacement, Hip / Q000295:instrumentation*; D001863:Bone Screws / Q000009:adverse effects*; D005263:Femoral Artery / Q000293:injuries*; D005528:Foot / Q000601:surgery; D005548:Foreign-Body Migration / Q000150:complications*; D006622:Hip Prosthesis / Q000009:adverse effects*; D006801:Humans; D007511:Ischemia / Q000209:etiology; D008297:Male; D008875:Middle Aged; D011475:Prosthesis Failure / Q000009:adverse effects*; D012086:Reoperation; D013923:Thromboembolism / Q000209:etiology; D016896:Treatment Outcome