Conservative Management in Total Knee Arthroplasty with Vascular Compromise: A Case Report

Background: Vascular complications following total knee replacement (TKR) are rare but potentially limb-threatening.Prompt recognition and management are crucial for preserving limb function.Case presentation: We report a 57-year-old woman with bilateral grade III knee osteoarthritis (OA) who underwent simultaneous bilateral cemented TKR.Postoperatively, the patient developed non-palpable dorsalis pedis and posterior tibial pulses in the left lower limb, with Doppler revealing reduced arterial flow suggestive of arterial spasm or partial thrombosis.Conservative management with anticoagulants and antiplatelets was initiated, alongside close monitoring.Outcome: Distal pulses returned by postoperative day 2 without further complications, and the patient achieved full recovery of limb function without the need for surgical intervention.Conclusion: This case highlights the importance of vigilant postoperative vascular assessment following TKR.Early detection and conservative management can prevent progression to critical ischemia, avoiding surgical intervention while ensuring limb salvage.