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

Ivet Koleva; Frederic Milvoy; Borislav Yoshinov

Ivet Koleva Medical University of Sofia, Bulgaria.
Frederic Milvoy Hospital �St Amand Montrond, France.
Borislav Yoshinov Medical Faculty, Sofia University, Bulgaria.

Keywords: Knee arthroplasty, complication, arteritis, rehabilitation, physiotherapy

Abstract

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 supra-articular 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 patients 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.