Profunda Femoris Artery Branch Pseudoaneurysm following Total Hip Arthroplasty

Abstract

We discuss the case of patient who suffered a profunda femoris artery branch pseudoaneurysm following total hip arthroplasty. Notably this is a rare occurrence following anterolateral approach total hip arthroplasty. Adding to the diagnostic difficulty was the timing of presentation occurring in the subacute rather than the acute post-operative period. Presentation of a pseudoaneurysm following hip surgery can be variable. It is vital to note diagnostic clues as pseudoaneurysm can pose catastrophic consequences to the patient.

Pseudoaneurysm of the Profunda Femoris Artery following Blunt Trauma Treated by Endovascular Coil Embolization: Review of Two Cases and Relevant Literature

“…The pseudoaneurysm was suspected to be caused not by the fracture but rather by the bone spikes; this was determined due to the distance of the PFA injury from the fracture and surgical site [ 12 ]. Another case of iatrogenic PFA pseudoaneurysm was described by Karmakar and Horsley during a total hip arthroplasty in which the sharp Hohmann retractor was likely the cause of the injury [ 13 ]. The authors suggested an alternate hypothesis in which excessive retraction was the cause of the injury [ 13 ].…”

“…Another case of iatrogenic PFA pseudoaneurysm was described by Karmakar and Horsley during a total hip arthroplasty in which the sharp Hohmann retractor was likely the cause of the injury [ 13 ]. The authors suggested an alternate hypothesis in which excessive retraction was the cause of the injury [ 13 ]. Use of a blunt Hohmann retractor was recommended by the authors as a result [ 13 ].…”

“…The authors suggested an alternate hypothesis in which excessive retraction was the cause of the injury [ 13 ]. Use of a blunt Hohmann retractor was recommended by the authors as a result [ 13 ]. Another incident in the literature concerning PFA pseudoaneurysm following total hip arthroplasty, described by Huynh et al, suggested that inappropriate use of the Hohmann retractor was again the source of the injury [ 14 ].…”