Pseudoaneurysm of the Lateral Genicular Artery Following Unicompartmental knee Arthroplasty: A Rare Case Report.

Abstract

Unicondylar knee replacement is a minimally invasive technique of surface replacement of the knee joint. Very little literature is available regarding vascular complications in patients who undergo this procedure due to their extremely rare nature. This first-of-its-kind report describes a case of pseudoaneurysm of the lateral genicular artery of the right knee in a hypertensive, 65-year-old man, following a single sitting bilateral unicompartmental knee replacement (UKR). With no involvement of the lateral compartment in UKR, we suspect an underlying mechanical element as the cause of the pseudoaneurysm. Patient presented with swelling and pain in the right knee for the first time at 8-month postoperatively, and after aspiration of the hemarthrosis, had two events of recurrence with increasing frequency. Dynamic magnetic resonance angiography confirmed the diagnosis and the patient underwent angiography-guided embolization of the lateral genicular artery using polyvinyl alcohol particles, with no recurrence in over a year since then. Pseudoaneurysm of the lateral genicular artery is a possible cause of recurrent hemarthrosis even after unicondylar knee replacement and requires a high degree of suspicion for its timely diagnosis and management.