Tiftikçi Uğur, Serbest Sancar
Department of Orthopaedics and Traumatology, Faculty of Medicine, Kırıkkale University, Kırıkkale, Turkey.
Clin Interv Aging. 2015 Dec 17;10:1967-70. doi: 10.2147/CIA.S97230. eCollection 2015.
A femoral artery aneurysm is a very rare complication of hip surgery treatment. In this presentation, we report a rare case of bone destruction caused by the femoral artery aneurysm after a hip hemiarthroplasty operation as a late stage complication. A 77-year-old male patient presented with swelling and pain in the hip without any signs of ischemia. X-ray showed a 7 cm bone destruction in the medial cortex of the proximal femur. After ultrasound imaging, a femoral artery aneurysm was diagnosed. The patient was operated on by vascular surgeons, and a large amount of organized hematoma with artery aneurysm was removed. The diagnosis of femoral aneurysm after hip surgery treatment can be difficult. Femoral aneurysm is rare and usually secondary to trauma, infection, or iatrogenic injury. We assumed that this case occurred during the hemiarthroplasty operation, caused by a compressing effect to the bone causing destruction. The patient was followed for 2 years, during which time the preoperative symptoms reduced dramatically and Harris Hip Score improved. After a hip arthroplasty operation, it must be kept in mind that a femoral arterial aneurysm can cause persistent symptoms. This case illustrates the importance of considering a pseudoaneurysm as a possible cause of periprosthetic osteolysis, particularly if rapid progressive growth has occurred. If this vascular injury had not been correctly diagnosed, the method of treatment could have been much different, probably with catastrophic consequences.
股动脉瘤是髋关节手术治疗中一种非常罕见的并发症。在本病例报告中，我们报道了1例髋关节半关节置换术后股动脉瘤导致骨破坏的罕见病例，这是一种晚期并发症。1例77岁男性患者出现髋关节肿胀和疼痛，无任何缺血迹象。X线显示股骨近端内侧皮质有7 cm的骨质破坏。经超声检查后，诊断为股动脉瘤。患者接受血管外科医生手术，清除了大量伴有动脉瘤的机化血肿。髋关节手术治疗后股动脉瘤的诊断可能具有挑战性。股动脉瘤罕见，通常继发于创伤、感染或医源性损伤。我们推测该病例发生在半关节置换手术期间，是由于对骨骼的压迫作用导致破坏。对患者进行了2年随访，在此期间术前症状显著减轻，Harris髋关节评分提高。髋关节置换手术后，必须牢记股动脉动脉瘤可能导致持续症状。本病例说明了将假性动脉瘤视为假体周围骨溶解可能原因的重要性，特别是如果出现快速进展性生长。如果这种血管损伤未得到正确诊断，治疗方法可能会大不相同，可能会产生灾难性后果。
