Two Cases of Vascular Complications following Bipolar Hip Arthroplasty.

概要

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We report 2 cases of vascular complications experienced in 76 bipolar hip arthroplasties (BHA) carried out since 1987. Case 1 was a 58-year-old woman with bilateral OA hip. Left BHA and acetabular plasty using resected femoral head were performed. Low blood pressure and progressing anemia were observed after surgery. Anemia persisted for 3 days in spite of blood infusion. Abdominal CT scan revealed retroperitoneal hematoma (700ml). Femoral vein obstruction was found on venography. It was suspected that injury to the external iliac vein occurred during acetabular drilling for reconstruction of acefabular roof using femoral head. Case 2 was a 75-year-old woman with right OA hip. Right BHA was performed without any trouble. On the 2nd postoperative day, she developed sudden dyspnea, cyanosis and shock. In spite of cardiopulmonary resuscitation and intensive care, she died 2 hours later. Ultrasonic cardiogram showed a dilatated right ventricle and filling failure of the left ventricle. A massive pulmonary embolism was found on pulmonary angiogram. In conclusion, accidental perforation of the external iliac vessels can be avoided by careful planning and careful surgical techniques. In a case with massive pulmonary embolism, immediate diagnosis and removal of thrombus may save the patient.