Popliteal artery pseudoaneurysm after total knee replacement

Abstract

We report the case of a popliteal pseudoaneurysm following total knee replacement. A 70-year-old woman underwent total left knee replacement because of severe osteoarthritis. Eight days later she presented with oedema and pain in her left calf She had palpable foot pulses on the left leg and the ankle-brachial index was 0.98. The patient was treated for deep vein thrombosis. Two days later her calf pain and oedema deteriorated and her distal pulses were no longer palpable, while she developed limb coldness and paraesthesia, and the ankle-brachial index dropped to 0.4. Sonography was urgently performed indicating a large popliteal artery aneurysm (5.8 x 6.9 x 7.2 cm), confirmed by angiography. The patient was managed with removal of a 3.5 cm long segment of the popliteal artery and reconstruction with synthetic graft (PTFE 6 mm). Her condition soon improved and the patient is capable of walking approximately 1 km per day at 18-month follow-up.