Profunda Femoris Artery Pseudoaneurysm Following Primary Total Hip Arthroplasty: A Rare Vascular Complication with Review of Literature
Anu Ranjan1*, Prateek Gupta1, Hariharan Triplicane Dwarakanathan1, Rohit Maheshwari1
1Golden Jubilee National Hospital, Glasgow, United Kingdom.
*Corresponding Author: Anu Ranjan, Golden Jubilee National Hospital, Glasgow, United Kingdom.
https://doi.org/10.58624/SVOAOR.2026.06.006
Received: January 14, 2026
Published: February 17, 2026
Citation: Ranjan A, Gupta P, Dwarakanathan HT, Maheshwari R. Profunda Femoris Artery Pseudoaneurysm Following Primary Total Hip Arthroplasty: A Rare Vascular Complication with Review of Literature. SVOA Orthopaedics 2026, 6:1, 46-50. doi: 10.58624/SVOAOR.2026.06.006
Abstract
Background: Vascular injury following total hip arthroplasty (THA) is rare, with an estimated incidence of 0.16–0.25%. Pseudoaneurysm of the profunda femoris artery (PFA) represents an exceptionally uncommon subset, accounting for less than 0.05% of vascular complications. Early diagnosis is essential to prevent rupture and ischemic sequelae.
Case Presentation: A 71-year-old female underwent elective primary left total hip arthroplasty through a posterior approach for advanced osteoarthritis. The immediate postoperative course was uneventful; however, on the ninth postoperative day, she developed acute left thigh pain, progressive swelling, and foot drop with absent distal pulses. Computed tomographic angiography revealed a PFA pseudoaneurysm measuring 16 × 20 mm with contained rupture and submuscular hematoma. Despite initial ultrasound-guided thrombin injection, the lesion enlarged to 22 × 24 mm. Urgent open vascular exploration identified a focal arterial wall defect, which was repaired primarily with restoration of luminal continuity. The postoperative period was stable, with restoration of distal circulation and satisfactory functional recovery.
Conclusion: Profunda femoris artery pseudoaneurysm is a rare but critical vascular complication that may occur even after primary THA due to indirect iatrogenic arterial injury. Prompt diagnosis using computed tomographic angiography and early surgical or endovascular intervention are vital to prevent catastrophic outcomes.
Keywords: Total hip arthroplasty, Profunda femoris artery, Pseudoaneurysm, Computed tomographic angiography, Vascular repair