Arterial complications of total knee replacement
C. E. McAuley, D. L. Steed and M. W. Webster
Arterial complications of total knee replacement are rare but may be more
frequently encountered as the number of replacement arthroplasties
increases. An arterial injury may occur on either an acute or chronic
basis, leading to ischemia of the lower extremity. The mechanism of injury
may be analogous to that encountered in the popliteal artery entrapment
syndrome, but may also result from disruptive forces applied to calcified
atherosclerotic vessels by the pneumatic tourniquet or during
intraoperative manipulation. A thorough preoperative vascular evaluation
should be routinely performed in patients with evidence of coexisting
peripheral arterial disease, and baseline Doppler segmental pressures
should be obtained. Early detection of an arterial injury may prevent the
serious consequences that might otherwise occur.
