Popliteal artery injury after total knee arthroplasty.

Total knee arthroplasty (TKA) is a commonly performed orthopedic procedure. The incidence of vascular complications after TKA is low. However, these complications may be debilitating, limb-threatening, and potentially avoidable. Our first patient, who had no preexisting vascular occlusive disease, developed an ischemic extremity after TKA. The second patient underwent TKA and was diagnosed with a severely ischemic limb 48 hours postoperatively. Both patients underwent above-knee to below-knee popliteal artery saphenous vein bypass grafting. Although limb salvage was obtained in both cases, one had a significantly neuropathic foot. In conclusion, long-term morbidity can be avoided by early identification and treatment of ischemia by bypass grafting.