Delayed Diagnosis of Ischemia after Popliteal Artery Injury during total Knee Arthroplasty

Abstract

Over 600,000 TKA are performed annually in the USA. Injuries to the popliteal artery are unusual, estimated to occur in less than 0.2% of cases [1-3]. Three mechanisms of injury have been reported, the use of a pneumatic tourniquet in patients with advanced atherosclerosis [4], sharp, direct trauma to the vessels and stretching or kinking of the artery when the knee is manipulated [5,6]. It is generally believed that popliteal artery occlusion rapidly causes acute ischemia after popliteal artery occlusion because of the paucity of collaterals. Cases of acute ischemia after TKA that slowly evolve and that have been diagnosed and treated on a delayed basis have been rarely reported [3]. This may be because delays in diagnosis frequently result in major morbidity and litigation.