Pseudoaneurysm of the Superficial Femoral Artery after Knee Arthroscopy

An 84 year old gentleman underwent knee arthroscopy. He had x-ray proven left knee osteoarthritis. He had a number of medical co-morbidities including being on an anticoagulant for atrial fibrillation. He did not want a knee replacement. A knee arthroscopy was performed which confirmed severe left knee osteoarthritis. Debridement of degenerative meniscus was performed. Three weeks post-operatively, the patient presented to the emergency department complaining of swelling and pain in his lower limb. He underwent an ultrasound venogram to look for a deep venous thrombosis (DVT). He was diagnosed with a pseudoaneurysm (PSA) of the superficial femoral artery (SFA). Subsequently, he was referred to the vascular surgery service who treated the PSA with covered stenting. The thigh and knee pain dissipated almost immediately. We propose that this is the first PSA of the left SFA to be documented after a knee arthroscopy. The authors would like to acknowledge that knee arthroscopy for severe osteoarthritis is rarely performed in an octogenarian. However, as this patient had declined a total knee replacement (TKR) and injections were no longer providing him relief, knee arthroscopy was performed.