Popliteal Artery Injury During Total Knee Replacement: A Single-Center Experience

The popliteal arteries are rarely injured during total knee replacement. Although uncommon, these complications warrant attention because the consequences can be disastrous, with high mortality rates, amputation risk, and additional comorbidities such as foot drop, infection, and functional impairment. However, it has detrimental consequences for the patient. Avoiding such injuries starts with preoperative planning, which helps prevent injuries. Furthermore, preoperative planning prompts early recognition and facilitates immediate interventions to reduce complications. We presented the case of a 59-year-old female following up in an orthopedic outpatient clinic for advanced bilateral knee pain, which became more progressive in the past year. The patient had tried conservative treatment with minimal improvement and elected for total knee replacement. The operation was performed as standard. However, while trying to clear the posterior tissue, an accidental complete cut to the popliteal artery occurred. After that, the vascular surgeon performed direct repair of continuous anastomosis. Following that, distal pulses and capillary refill were felt by the surgeon to be intact. Finally, the operation was completed uneventfully. Later, the patient was discharged home in good condition and had no complications upon follow-up.