Arterial complications following total hip arthroplasty in a patient with a femoro-femoral bypass

Abstract Purpose To report on the occlusion of a femoral artery bypass, an unusual complication of primary total hip replacement. Clinical case A 74-year-old male with a femoro-femoral implant and a Dacron graft suffered arterial ischemia resulting from thrombosis of the vascular graft further to total hip replacement. We present a brief bibliographical review of arterial complications following total hip arthroplasty. Discussion As the patient was operated through a posterolateral approach, we thought that the complication was caused by the limb adduction and internal rotation maneuvers that are required in such procedures, which Could have bent the graft thereby causing a thrombus to be formed. Conclusions In addition to a careful preoperative vascular assessment, care must be taken in these cases with the maneuvers carried out on the limb during femoral preparation. As it is advisable to avoid the extreme flexion, adduction and internal rotation maneuvers necessary for the posterolateral approach, the anterior approach should be selected.