Mechanisms of arterial injuries associated with total hip replacement
J. C. Aust, C. E. Bredenberg and D. G. Murray
Five cases of arterial complications of total hip replacement, all of which
can be explained on the basis of intraoperative injury, are reported, with
diagrammatic analysis of the intraoperative mechanisms of injury involved.
The injuries were manifested as hemorrhage, ischemia, or development of a
pulsatile mass. Vascular structures affected include the external iliac,
common femoral, medial femoral circumflex, and lateral femoral circumflex
arteries. Arterial damage may result from retractor injury, thermal injury
from methylmethacrylate, or direct penetration from polymer or gouging
during acetabular preparation. An understanding of the mechanisms and
location of arterial injury following hip replacement will aid the vascular
surgeon in diagnosis, exposure, and repair of these injuries.
