Between 1980 and 1990 a total of 17 patients who had undergone or had been selected for total hip replacement were treated in the Department of Surgery at Münster University. Angiographic studies performed because of persistent symptoms revealed circulatory disorders of the pelvic floor. Vascular surgery was necessary to eliminate symptoms in these patients. Postoperative complications in 3 patients following total hip replacement were also only eliminated by vascular surgery. In the present authors' view, failure to recognize preoperatively existing arterial circulation disorders can lead to misdiagnosis and severe postoperative complications. Every hip replacement operation should be preceded by a thorough clinical and--if doubt persists--an angiological examination. Documented arterial circulation disorders should be eliminated by vascular surgery prior to hip surgery.