Recurrent Knee Dislocation With Vascular Injury in a Patient With Prior Total Knee Arthroplasty: A Case Report

TL;DR

A 71-year-old woman with a history of total knee arthroplasty experienced multiple dislocations and a popliteal artery injury, highlighting the rare but serious risks of TKA dislocations.

Contribution

This case report highlights the rare but severe vascular complications of TKA dislocations and emphasizes the need for prompt diagnosis and treatment.

Findings

The patient suffered a popliteal artery injury following TKA dislocations, requiring immediate bypass surgery.

Complications included recurrent dislocation, thrombus, infection, and stenosis, all requiring intervention.

The case underscores the importance of CT angiography for suspected knee dislocations in TKA patients.

Abstract

Vascular injury after total knee arthroplasty (TKA) is exceedingly rare, with the potential to have catastrophic consequences. This injury has the potential to become more common with the rising incidence of this procedure and an aging population.

We present a case of a 71-year-old woman who suffered from chronic instability and multiple dislocations of TKA following two falls from standing, both of which occurred and were observed in the hospital. She sustained a popliteal artery injury, with a subsequent bypass performed the same day. The course was complicated by recurrent dislocation requiring external fixation, thrombus, infection, and stenosis, all of which required intervention.

There are grave consequences to TKA dislocations, and clinicians should keep a high level of suspicion for and a low threshold to obtain CT angiography in any patient with concern for knee dislocation. TKA incidence will continue to rise as the population ages, and dislocation can lead to significant injury, morbidity, and even mortality. It must be considered, even in low-energy trauma, quickly recognized and treated with specialty assistance.

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