Vascular Complications in Joint Arthroplasty
Summary
Joint arthroplasty is among the most successful interventions for osteoarthritis and other degenerative joint diseases. Despite its overall safety, vascular complications remain rare but carry potentially serious consequences including limb ischaemia, pseudoaneurysm formation and life-threatening haemorrhage. These complications arise from direct vessel trauma, stretch injury during joint manipulation or cement leakage. The most commonly affected structures are the popliteal artery in knee replacement and the profunda femoris or external iliac arteries in hip procedures. Early recognition often relies on vigilant postoperative monitoring for symptoms such as acute pain, swelling, absent pulses or unexplained anaemia. Advances in imaging—principally duplex ultrasound and computed tomography angiography—have improved diagnostic accuracy, while therapeutic options range from open vascular repair to minimally invasive endovascular approaches. A multidisciplinary strategy integrating orthopaedic and vascular expertise is fundamental to reducing morbidity and preserving limb function. Ongoing research focuses on refining risk stratification, optimising perioperative imaging protocols and developing standardised algorithms to guide timely intervention.
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Vascular Complications in Joint Arthroplasty publication trend
The graph below shows the total number of articles in vascular complications in joint arthroplasty across all publications each year (not limited to Nature Index journals).
Technical terms
Pseudoaneurysm: A contained breach in the arterial wall causing a sac of blood that communicates with the vessel lumen.
Endovascular embolisation: A minimally invasive procedure that deploys materials within a vessel to occlude abnormal blood flow.
Thrombectomy: The surgical or mechanical removal of a thrombus to restore normal blood flow in an occluded vessel.
Ischaemia: A state of reduced blood supply to tissues, leading to pain and risk of necrosis if not promptly corrected.
Angiography: An imaging technique that visualises the interior of blood vessels following the injection of a radiopaque contrast agent.
References
- Profunda Femoris Pseudoaneurysm following Total Hip Arthroplasty Revision. Case Reports in Orthopedics (2015).
- Iatrogenic injury of the popliteal artery in orthopedic knee surgery: clinical results and development of a therapeutic algorithm. European Journal of Trauma and Emergency Surgery (2022).
- Acute Popliteal Artery Thrombotic Occlusion Post Total Knee Arthroplasty in a Patient With Antiphospholipid Syndrome: A Report of a Rare Complication. Cureus (2023).
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