We experienced one case of left knee total knee arthroplasty (TKA) after artificial vascular bypass surgery for both femoral arteries from the right inguinal region. Patients requiring TKA after arterial bypass surgery to report a thrombosis are very rare, but the incidence of thrombosis in the cases of TKA after arterial bypass surgery was reported to be higher when compared to the incidence of acute arterial occlusion after common TKA. When TKA is performed in such a patient, a strict anticoagulation therapy is necessary to perform assessment of vascular status carefully pre- and postoperatively. Further, it is important to perform surgery with consideration of intraoperative procedures such as no use of tourniquets during surgery. In addition, if a postoperative ischemia is suspected, it is necessary to perform emergent vascular reconstructive surgery immediately.
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