False aneurysm of the common femoral artery after total hip arthroplasty. A case report.
A 59-year-old healthy man presented with osteoarthritis of his left hip that was recalcitrant to nonoperative treatment. He subsequently elected to have arthroplasty of the hip performed. At 3 months after arthroplasty, he returned reporting progressive groin pain: most remarkable was a palpable mass in the groin region. An arteriogram showed a radiodense mass adjacent to the acetabulum, and a computed tomography scan with contrast confirmed a large false aneurysm originating from the common femoral artery. In this particular case, a pointed Hohmann retractor punctured the common femoral artery, creating the dynamics of the development of a false aneurysm. Primary suture repair of the vascular defect was performed, followed by a complete and uncomplicated recovery of the patient to full activity. Since this case, the authors have discontinued the use of pointed. Hohmann retractors and now use a blunt, rounded Hohmann retractor during total hip arthroplasty without compromising acetabular exposure. However, care must be taken in blunt retractor placement to avoid retractor slippage during the procedure. This case shows the need for awareness of potential mechanisms for vascular injury related to total hip arthroplasty.