Claudication,Tibial Neuropathy,and Peripheral Lymphedema after Total Knee Arthroplasty

Abstract

Vascular complications associated with orthopedic procedures, though rare, pose the potential for permanent disability or limb loss. Thermal, mechanical, and vibratory forces incurred during total knee arthroplasty may traumatize the popliteal artery leading to thrombosis, laceration, dissection, arteriovenous fistula, or pseudoaneurysm formation. Color duplex ultrasound (8 MHz), followed by digital subtraction angiography promptly diagnosed a large left popliteal artery pseudoaneurysm. Definitive surgical intervention via a posterior approach permitted direct arterial repair, venous decompression, and tibial neurolysis. There were no neurovascular sequelae. Adherence to both preoperative vascular assessment and meticulous surgical technique are crucial to mitigate against this potentially catastrophic injury.