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

Introduction: Routinely patients with hip or knee arthroplasty are transferred from acute clinic to
rehabilitation department 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 supraarticular
arteria (aneurysm of 30 mm), missing images of retro & supra-articular popliteal arteriae.
Urgent operation was realized for the left leg diagnosed with Arteritis: Femoro-peroneal distal by-pass
graft in the intern saphenous vein with angioplasty of the distal anastomosis. After the operation, the
rehabilitation process was adapted to this tardive complication.
Discussion: In every case our goal is to prevent possible complications and to assure a high quality
of the rehabilitation, respectively – an improvement of the patient’s quality of care and quality of life.
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.