[Perioperative fatal bleeding: link between acetabular anchoring of a cementless implant]. / Perioperative tödliche Blutungskomplikation: Lagebeziehung zwischen azetabulären Verankerungen einer zementfreien Hüftpfanne und den Iliakalgefässen.

ABSTRACT

This case report concerns a 75-year-old patient who suffered haemorrhagic shock and mors in tabula during implantation of a total hip arthroplasty. The cause was established as an injury of the external iliac vein, probably as a result of the predrilling of holes for the anchoring screws and pegs. The surgical method and topographic anatomy of the operating area are presented. Such vascular injuries are a rare but life-threatening complication of this procedure; the literature quotes a frequency of about 0.3%. So far, no fulminate venous bleeding process has been reported. Complications in such operations cannot always be avoided. However, detailed knowledge of the acetabular geometry can provide more safety for the surgeon when carrying out the secondary anchoring of a press-fit implant.