Rupture of External Iliac Artery during Total Hip Arthroplasty after Rotational Acetabular Osteotomy: A Case Report

INTRODUCTION: Total hip arthroplasty (THA) is widely accepted as a safe and effective procedure to relieve hip pain and restore function, but complications can lead to a poor outcome. Although major vascular injuries during THA are rare, when they do occur, massive bleeding may threaten life. CASE REPORT: We describe a case of a 72-year-old woman who underwent THA after rotational acetabular osteotomy (RAO). When the soft tissue in the acetabular fossa was dissected with electrocautery, massive pulsatile bleeding suddenly occurred. A blood transfusion and metal stent graft repair saved her life. We assume that the cause of the arterial injury was a bone defect of the acetabulum and relocation of the external iliac artery after RAO. CONCLUSION: To avoid arterial injury during THA, pre-operative three-dimensional computed tomographic angiography to locate the intrapelvic vessels around the acetabulum is recommended in cases with complex hip anatomy.