Penetrating Bladder Injury Caused by a Medially Placed Acetabular Screw

Cancellous bone screws are used frequently to improve the early stability of hydroxyapatite (HA) coated acetabular components during total hip arthroplasty.1-4 Occasional complications  have been reported: medially  placed screws may cause neurovascular damage,  especially to the external iliac and obturator vessels, and the sciatic and obturator nerves.1-5  Avoidance of the anterosuperior and anteroinferior quadrants is recommended for transacetabular screw placement.1-5 Although it has not previously been considered an at risk  structure, I report a case of bladder injury associated with a medially placed acetabular screw.