Anterior tibial artery pseudoaneurysm secondary to articulating spacer use for infected knee arthroplasty: A case report

Introduction: Neurovascular compromise following primary or revision total knee arthroplasty is a rare but severe complication. To the best of our knowledge, there have been reports of pseudoaneurysm of the popliteal artery following primary and revision; however, an anterior tibial artery pseudoaneurysm with articulating spacer has not been described yet. Case presentation: We introduce a rare case of anterior tibial artery pseudoaneurysm and concomitant foot drop caused by an articulating spacer in a two-stage revision for infected knee replacement. Displacement of the articular spacer was observed on knee x-rays. Hematoma and pseudoaneurysm were detected. The patient was operated on urgently, and a pseudoaneurysm originating from the anterior tibial artery was intraoperatively observed. Discussion: Vascular complications following TKA are rare but could be limb-threatening and even life- threatening. If postoperative displacement of the articulating spacer is observed with neurovascular symptoms, orthopedic surgeons should be alerted to the possibility of a pseudoaneurysm. Conclusion: Although rare, anterior tibial artery pseudoaneurysm should be considered among vascular injuries in revision knee arthroplasty cases.