Delayed Arterial Complication Following Femoral Cerclage Cab
Vascular complications following femoral cerclage cabling and wiring in total hip arthroplasty are uncommon. We present a case of unusually late symptoms after an arterial injury secondary to cerclage cabling in the setting of femoral shaft cortical strut grafting.

Case Report:
A 50 year-old morbidly obese female presented with left anterior thigh pain two years after total hip replacement performed by another surgeon. Following a thorough infectious and aseptic loosening workup, it was determined that her source of pain was likely from anterior and lateral femoral stem cortical bone remodelling, around the large and stiffer femoral prosthesis (figure 1). After several months of conservative treatment, the patient continued to have debilitating anterior thigh pain with activities and with rest. Risks and benefits of allograft fibular strut grafting and cerclage cabling around the area of femoral stress reaction was discussed, and the patient wished to proceed surgically. Surgery was undertaken with femoral strut grafting and cabling and concluded without any apparent intraoperative complications.

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