A case of late iliac arterial thrombosis due to component migration after revision total hip arthroplasty

Abstract

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. A few previous reports have described embolic distal limb ischemia secondary to a failed and migrated acetabular implant in discontinuity with the pelvis. We present a rare case in which a support ring from a failed and migrated acetabular cage construct led to injury of the common femoral artery. The patient developed acute thrombotic occlusion leading to distal extremity ischemia even after oral anticoagulant therapy. The patient was treated with embolectomy with a Fogarty catheter, replacement of the injured common femoral artery with an InteRing 8mm, and removal of the offending hardware. Recognition of the risks associated with failed and migrated components is important to prevent this complication for cardiologists as well as orthopedic surgeons.<Learning objective: 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. Recognition of the risks associated with failed and migrated components is important to prevent this complication for cardiologists as well as orthopedic surgeons.>