Vascular injury as a complication of knee arthroscopic surgery. Report of two cases and review of the literature

Background: Arthroscopy of the knee is a surgical performed World-wid considered extremely safe, rates of complication ranging from 0.56 to 8.2%. Vascular complications are even more rare (0.0032%), and generally related to the popliteal artery injury. Clinical case: We are reporting the cases of two patients who had unsuspected vascular complications after arthroscopy. Both cases presented vascular injuries after elective knee arthroscopy. First case was a patient with thrombosed pseudoaneurysm in the popliteal artery and total section of the popliteal vein, unfortunately the diagnosis was done 72 hrs after knee arthroscopy and finally required amputation, the 2nd case presented popliteal arteriovenous fistula, the diagnosis was done 3 weeks after knee arthroscopy, the patient was successfully treated by resection of the fistula and direct repair of the artery and vein. Conclusions: Although extremely infrequent, the vascular injury after knee arthroscopy should be remembered as a surgical complication, a low index of suspicion may have caused an unfortunate and untimely delay in diagnosis and treatment with potential risk of leg amputation and death.