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Arterial Complications and Total Knee Arthroplasty

Dr. Smith is Research Associate, Department of Orthopaedics, University of British Columbia, Vancouver, Canada. Dr. McGraw is Professor, Division of Reconstructive Orthopaedics, Department of Orthopaedics, University of British Columbia. Dr. Taylor is Associate Professor and Head, Division of Vascular Surgery, Department of Surgery, University of British Columbia. Dr. Masri is Associate Professor and Head, Division of Reconstructive Orthopaedics, Department of Orthopaedics, University of British Columbia.

Reprint requests: Dr. Masri, Department of Orthopaedics, Third Floor, 910 West 10th Avenue, Vancouver, BC, Canada V5Z 4E1.

Arterial complications after total knee arthroplasty (TKA) are rare; however, the sequelae can be disastrous. Infection and the need for amputation or vascular reconstructive surgery are not uncommon. A thorough preoperative assessment can identify at-risk patients, many, if not all, of whom have preexisting peripheral arterial disease. In the presence of peripheral arterial disease, the use of a tourniquet during TKA has been implicated in subsequent arterial complications. Following the guidelines that have been established regarding preoperative assessment, the role of the vascular surgeon, and the use of a tourniquet before and during TKA can assist the orthopaedic surgeon in assessing candidates for TKA and reducing the risk of arterial complications.

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