Effect of total knee arthroplasty on blood flow to the lower limb: a prospective clinical study and review of literature.

Ischemic complications after total knee arthroplasty (TKA) are rare. There is a reported association with chronic lower extremity ischemia (CLEI), however. This prospective study examined changes in blood pressure in the lower limb during the early postoperative period. Arterial blood pressure was assessed before and after TKA by the ankle brachial pressure index (ABPI) using Doppler ultrasonography. Seven patients with CLEI (ABPI <0.9) and 33 patients with normal vascular status (ABPI >0.9) were studied. An ABPI of 0.65, correction of minor knee deformity, and a tourniquet time of 2 hours did not alter arterial blood pressure. TKA does not affect the distal arterial blood pressure in the lower limb in normal and CLEI-affected limbs in the immediate postoperative period.