External iliac vein compression secondary to osteolysis-induced hematoma in total hip arthroplasty—a case report and brief review of the literature

Alvin K. Shieh, Zachary C. Lum, Avreeta K. Singh, Gavin Caesar Pereira

Research output: Contribution to journalArticle

Abstract

A 62-year-old man with a history of right total hip arthroplasty, who was managed conservatively for moderate osteolysis, presented with acute-onset, painless, significant, and diffuse right lower extremity edema. Initial laboratory markers were negative for infection. Advanced imaging demonstrated a complex extrapelvic fluid mass along the psoas sheath causing compression of the external iliac vein. Intraoperatively, significant hematoma was removed from the iliopsoas sheath, followed by metal head and liner exchange as well as bone grafting of the osteolytic defects adjacent to the hip implant. Postoperative imaging showed adequate decompression, no deep vein thrombosis, and a patent external iliac vein. At 2 weeks, postoperative swelling completely resolved. At 3 months, the patient recovered to normal baseline level and underwent contralateral total hip arthroplasty for symptomatic osteoarthritis.

Original languageEnglish (US)
JournalArthroplasty Today
DOIs
StatePublished - Jan 1 2019

Fingerprint

Iliac Vein
Osteolysis
Hematoma
Hip
Arthroplasty
Bone Transplantation
Decompression
Venous Thrombosis
Osteoarthritis
Lower Extremity
Edema
Biomarkers
Metals
Infection

Keywords

  • Iliac vein compression
  • Leg edema
  • Leg swelling
  • Osteolysis
  • Total hip arthroplasty

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

Cite this

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abstract = "A 62-year-old man with a history of right total hip arthroplasty, who was managed conservatively for moderate osteolysis, presented with acute-onset, painless, significant, and diffuse right lower extremity edema. Initial laboratory markers were negative for infection. Advanced imaging demonstrated a complex extrapelvic fluid mass along the psoas sheath causing compression of the external iliac vein. Intraoperatively, significant hematoma was removed from the iliopsoas sheath, followed by metal head and liner exchange as well as bone grafting of the osteolytic defects adjacent to the hip implant. Postoperative imaging showed adequate decompression, no deep vein thrombosis, and a patent external iliac vein. At 2 weeks, postoperative swelling completely resolved. At 3 months, the patient recovered to normal baseline level and underwent contralateral total hip arthroplasty for symptomatic osteoarthritis.",
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