Pseudoaneurysm of a high-division anterior tibial artery following primary TKA

Arterial complications following total knee arthroplasty are rare but carry a high risk of significant morbidity and mortality. Herein, the authors report a case of pseudoaneurysm in a branch of a high-division anterior tibial artery caused by laceration by the retractor following primary total knee arthroplasty in a 72-year-old woman. The patient presented with an unexplained hematoma and an enlarging swelling, with pallor and acute hemorrhage on the first postoperative day. The diagnosis was confirmed by arteriography and the patient was successfully treated using endovascular embolization without long-term complications. Because of the high risk of progression to a potentially limb- or life-threatening condition, it is important to discuss the risk factors for this complication, as well as its early diagnosis and treatment methods. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi: 10.1007/s00132-016-3373-3) contains two videos on diagnosis and treatment of the pseudoaneurysm. The article and the supplementary material are available in the electronic archive at http://www.springermedizin.de/der-orthopaede.