Total knee arthroplasty in a patient with chronic occlusion of the superficial femoral artery

In a 67-year-old patient with severe valgus gonarthrosis and chronic occlus ion of the superficial femoral artery on the same side, total knee replacem ent was performed without preceding angioplasty because the collateral circ ulation was intact. No touriquet was used. To leave the peripatellar arteri al ring intact on one side in this case of lateral patellar maltracking, a lateral approach was used. In this approach, a lateral release forms part o f the approach itself. To achieve gentle eversion of the patella, the tibia l tubercle was osteotomized. One year postoperatively, the patient was sati sfied with the outcome and showed no clinical signs of any vascular deterio ration. It is concluded that total knee replacement may be possible in the presence of chronic occlusion of the superficial femoral artery provided th at the collateral circulation is intact.