Protrusio acetabuli presenting as a complex pelvic mass after total hip arthroplasty

Protrusio acetabuli: a rare cause of pulmonary embolus

Protrusio acetabuli is an uncommon complication of total hip arthroplasty, which results in intrapelvic implant migration after erosion of medial acetabular wall. We present a case of severe prosthetic migration with the formation of haematoma and impingement on iliac vessels leading to thrombosis and subsequent pulmonary embolus. This is the first reported case of protrusio acetabuli as a cause of pulmonary embolus.

Pelvic mass 21 years after total hip arthroplasty

Background. Long-term urologic complications after total hip arthroplasty are rare, and reports in the urologic literature are scant. We present a recent case and review the relevant literature. Case. A 77-year-old man was referred to the urology clinic for a single episode of gross painless hematuria, abnormal urine cytology, and pelvic mass. He had a significant smoking history. Surgical history included right total hip arthroplasty 21 years prior. Results. Pelvic ultrasound revealed a large mass abutting the right bladder wall. Subsequent computed tomography indicated that the mass was extrinsic to the bladder. Results of computed tomography-guided biopsy of the mass were consistent with foreign body granuloma. Surveillance imaging confirmed no growth or progression, and intervention was deferred. Conclusion. Long-term complications of total hip arthroplasty may present with signs and symptoms of urologic disease. Reports in the urologic literature are rare.