How to Approach an Injured Popliteal Artery During a Total Knee Arthroplasty

A 71-year-old male was consulted intraoperatively for a transected popliteal artery and vein after the cartilage osteophytes of both proximal tibia femur were removed total right knee arthroplasty. Both ligated with 2/0 silk sutures, incision closed temporarily. Incisions made to expose superficial femoral artery, obtaining distal controls. Intravenous heparin given greater saphenous harvested from contralateral thigh. The reversed, end anastomosed end-to-side above-knee 6/0 Prolene sutures. passed through previously fashioned tunnel heads gastrocnemius muscles. An anastomosis performed below-knee is slightly redundant reduce tension arthroplasty completed; anastomoses bled antegrade retrograde prior completion. patient had completed angiogram graft completed. showed patent bypass one-vessel runoff via peroneal distally reconstituted posterior tibial artery. No fasciotomy carried out due lack concern compartment syndrome. Although incidence injury rare during arthroplasty, patients’ outcomes vary depending on time diagnosis, ranging prolonged hospital stay amputation delayed diagnosis. risks increase hyperextension or hyperflexion operation, revision surgery, poor instrumentation intraoperatively, vascular diseases. locates laterally plateau (site typical resection arthroplasty); therefore, placing retractor medial midline avoid operation will injury. With late diagnosis treatment, mortality rate goes up 7% 42%. Therefore, timely treatment critical overall patients.