Arterial Vascular Complications after Total Knee Arthroplasty Decrease the Quality of Post-op Rehabilitation (A Case Report)

Abstract

Introduction: Routinely patients with hip or knee arthroplasty are transferred from acute clinic to rehabilitationdepartment at an ever earlier stage (one week post-op). The most frequent complications after lower extremity arthroplasty are: local pain, edema, contracture, tardive calcification, infection, hemorrhage, pulmonary embolism and deep vein thrombosis. Sometimes unexpected complications can provoke a delay or even suspension of the rehabilitation. Aims of the Study: The principal objective of the current article is to remind to the wide public the possible presence (and subsequent care) of other complications, e.g. the lower limb arteritis. Case Presentation: The presented patient is 77 years old male. Hospitalized in our PRM Department one week after operation, with the objective of post-op orthopedic rehabilitation after total knee arthroplasty (for advanced gonarthrosis - genu varum with angle 4°). Arterial Echo-Doppler of the lower extremities: Acute thrombosis of the left femoral superficial arteria, and the left popliteal supra-articular arteria (aneurysm of 30 mm), missing images of retro & supra-articular popliteal arteriae. Urgent operation was needed for the left leg diagnosed with Arteritis: femoro-peroneal distal pontage in the intern saphenous vein with angioplasty of the distal anastomosis. Discussion: In every case our goal is to prevent possible complications and to assure a high quality of the rehabilitation. Conclusion: Vascular complications after joint replacement can postpone or even interrupt the fluency of the rehab process. In every clinical case the PRM & OT medical doctors must be immediately alerted of any suspicion for complication or significant variation in expected progression / outcomes.