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Pseudoaneurysm of the Distal Thigh After Manipulation of a Total Knee Arthroplasty

  • Chris Sambaziotis, MD

      Affiliations

    • Department of Orthopaedic Surgery, Albert Einstein College of Medicine, MMC Greene, Bronx, NY 10467
  • ,
  • Mickey Plymale, MD

      Affiliations

    • Department of Orthopaedic Surgery, Albert Einstein College of Medicine, MMC Greene, Bronx, NY 10467
  • ,
  • Andrew Lovy, BA

      Affiliations

    • Department of Orthopaedic Surgery, Albert Einstein College of Medicine, MMC Greene, Bronx, NY 10467
  • ,
  • Kevin O'Halloran, MD

      Affiliations

    • Department of Orthopaedic Surgery, Albert Einstein College of Medicine, MMC Greene, Bronx, NY 10467
  • ,
  • Kenneth McCulloch, MD

      Affiliations

    • New York, NY 10022
  • ,
  • David S. Geller, MD

      Affiliations

    • Department of Orthopaedic Surgery, Albert Einstein College of Medicine, MMC Greene, Bronx, NY 10467
    • Corresponding Author InformationReprint requests: David S. Geller, MD, MMC Greene Medical Arts Pavilion 3400, Bainbridge Avenue, Bronx, NY 10467.

Received 15 February 2011; accepted 7 October 2011. published online 24 November 2011.
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Abstract 

The authors describe a unique complication after manipulation of a stiff total knee arthroplasty in a 47-year-old man. Four days after undergoing manipulation under anesthesia (MUA), the patient presented with increasing pain and swelling of the affected knee and decreased hemoglobin/hematocrit. Computed tomographic angiogram revealed a ruptured pseudoaneurysm of a segmental branch of the deep femoral artery that was treated with embolization and anterior thigh compartment fasciotomy. Although many complications of MUA have been described, we present a novel finding of a ruptured pseudoaneurysm. Ruptured pseudoaneurysm should be included in the differential diagnosis whenever a patient presents with pain and swelling of the thigh after MUA given its potential morbidity.

Keywords: manipulation under anesthesia, total knee arthroplasty, knee, stiffness, pseudoaneurysm

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 The Conflict of Interest statement associated with this article can be found at doi:10.1016/j.arth.2011.10.009.

PII: S0883-5403(11)00557-2

doi:10.1016/j.arth.2011.10.009

« BackThe Journal of Arthroplasty