Superficial Femoral Artery Pseudoaneurysm after Total Knee Arthroplasty: An Uncommon Vascular Complication.

Introduction: Total knee arthroplasty is widely recognized as a major advancement in orthopedic surgery, yet vascular complications, though rare, remain a clinically significant concern. While the popliteal artery is most frequently affected, isolated involvement of a more proximal vessel such as the superficial femoral artery (SFA) has been documented, although only in scattered case reports. Reported events range from hemorrhage to pseudoaneurysm formation and may occur months after surgery, making timely recognition of these injuries essential for preventing limb-threatening consequences. Case Report: We report a 72-year-old male with swelling in his right thigh 4 weeks following a bilateral total knee replacement. After physical examination, radiographs, Doppler, and computed tomography angiography, a probable diagnosis of a pseudoaneurysm from the SFA was made. It was confirmed on peripheral angiography through the common femoral artery and was embolized successfully by coiling. Conclusion: The author advocates the occurrence of pseudoaneurysm to the possibility of a tourniquet injury at the time of knee arthroplasty or an anesthetic procedure (post-operative block for analgesia) as the inciting event.