This article is about two patients having vascular injuries complicating total hip arthroplasty because of intraoperative indirect injuries. One patient had a delayed presentation of acute lower limb ischaemia, in which he required amputation of his left second toe because of ischaemic gangrene. The other patient had acute lower limb ischaemia leading to permanent muscle and nerve damage because of delayed recognition. Both patients had vascular interventions for the indirect vascular injuries.

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... Preoperative workup for suspicious underlying peripheral vascular disease, intraoperative precautions, and perioperative period of vascular status monitoring are essential for prevention and early detection of such sinister events.