Case: A 41-year-old man with Klippel-Trenaunay syndrome presented with pain and limited range of motion in his left hip due to secondary hip osteoarthritis. After preoperative assessment, which also included tomography and conventional arteriography, total hip arthroplasty by direct anterior approach was attempted, but rapid blood loss occurred during surgery and the procedure had to be stopped.
Conclusions: Total hip arthroplasty should be undertaken with great caution in a patient with Klippel-Trenaunay syndrome. Preoperative conventional arteriography alone may not reveal the true extent of vascular malformations, which may lead to catastrophic results.