Acetabular Bone Cement Extension Leading to Bladder Obstruction: An Orthopedic Surgical Complication

Polymethyl methacrylate, commonly known as bone cement, is widely used for implant fixation in orthopedic and trauma surgery due to its excellent adhesive properties and biocompatibility. However, complications such as bone cement extrusion, although rare, can lead to significant morbidity. We present the case of an 86-year-old Hispanic female who presented to the emergency department (ED) with tachycardia, hypertension, and respiratory distress. Her medical history included Parkinson's disease, hiatal hernia, osteoarthritis, colon cancer, and a complex post-hip fracture surgical history. Despite being bedridden, she had been previously in stable health. A computed tomography (CT) scan revealed a significant hiatal hernia, minimal remaining left lung tissue, a right lung nodule, hydronephrosis, and a large radiopaque mass in the right pelvis extending from the acetabular area. This radiopaque mass was later determined to be bone cement, with a portion extruding into the bladder. The patient was diagnosed with sepsis secondary to a urinary tract infection and hyponatremia; a urology consultation recommended a conservative approach to avoid potential antibiotic resistance. This case report highlights a rare complication of total hip arthroplasty involving bone cement extrusion into the bladder, which led to hydronephrosis and a urinary tract infection (UTI). Although such complications can be asymptomatic, they should be considered in patients with a history of arthroplasty.