Management of Thrombosis of the External Iliac Artery during Total Hip Arthroplasty – A Case Report

Abstract

Introduction: Vascular injury following total hip arthroplasty (THA) is uncommon but can lead to loss of life or limb. External iliac and common femoral arteries are commonly injured during THA. Case Report: We report a case of thrombosis of the external iliac and femoral artery during THA in a mid-60-year female patient with 15-year-old neglected fracture neck of the femur. Six hours following THA through Harding’s approach, a feeble pulse was palpated in the operated limb. Ischemia of the limb led to sciatic nerve palsy and foot drop in the operated limb, which was intact following surgery. Computed tomography angiography confirmed thrombosis of the external iliac and femoral artery. Removal of thrombosis with the use of a Fogarty catheter could save the limb and lead to recovery of foot drop. Early detection of pulselessness and timely intervention in the post-operative period was the cornerstone of this case report. Conclusion: Vascular injury during THA though rare but cannot be ruled out completely. Early diagnosis with a stringent post-operative protocol and timely intervention would be the cornerstone of the management of any vascular injury following THA. Keywords: Thrombosis, arthroplasty, external iliac artery, angiography.