Popliteal A-V Fistula with Pseudo-aneurysm: A Complication Following Total Knee Arthroplasty

Arthroscopy and total knee replacement (TKR) are the two orthopedic procedures in which instruments are routinely placed near the posterior capsule of the knee. A review of the literature demonstrated that the four commonest reported problems following TKR are thrombosis, arterial transection, A-V fistula, and aneurysm formation. Reports on popliteal artery injury with severe patient morbidity following arthroscopy and TKR have been described in the literature. Despite the uncommon occurrence of these injuries, the outcome can be devastating, leading to further surgery, including vascular repair or possibly even amputation of the affected limb. We present a rare case of popliteal A-V fistula following TKR and discuss the probable etiology and the management.