Migration of an acetabular component beyond the
ilio-ischial line is a rare but potentially lethal complication
following a total hip arthroplasty, because the
socket can become entrapped between the iliac vessels.
Pre-operative assessment of the position of the
socket relative to the intra-pelvic vascular structures
is always mandatory to set up a staged procedure
with a retroperitoneal exposure of the iliac vessels.
This allows for a safe mobilization and looping of the
vessels followed by extraction of the component
either through the retroperitoneal or standard surgical
approach to the hip joint. This strategy will minimize
the risk of disruption of the vessels and of
uncontrollable bleeding in case of vessel damage.