Popliteal artery damage during total knee arthroplasty

Area of Science:

• Orthopedic Surgery
• Vascular Surgery
• Medical Case Reports

Background:

• Popliteal artery injury is a rare but serious complication of total knee arthroplasty.
• These injuries can result from surgical manipulation, such as during tibial cuts or with retractor use.
• Delayed diagnosis can lead to significant morbidity.

Purpose of the Study:

• To report two distinct cases of popliteal artery injury during total knee arthroplasty.
• To discuss the classification, mechanisms, clinical presentation, diagnosis, and management of these vascular complications.
• To emphasize the importance of early diagnosis and appropriate treatment.

Main Methods:

• Case report of transverse semi-dissection of the popliteal artery during tibial cut.
• Case report of popliteal pseudoaneurysm formation secondary to Hohmann retractor use.
• Review of diagnostic modalities and open surgical management strategies.

Main Results:

• Early diagnosis and successful open surgical repair in the semi-dissection case.
• Delayed diagnosis in the pseudoaneurysm case due to initial misdiagnosis as deep vein thrombosis.
• Both cases ultimately achieved successful restoration of blood flow confirmed by clinical examination and ultrasound.

Conclusions:

• Popliteal artery injuries, though infrequent, require prompt recognition and management during total knee arthroplasty.
• A high index of suspicion and appropriate diagnostic tools are crucial for timely diagnosis.
• Open surgery remains a viable option for managing these vascular injuries, leading to successful outcomes.