M. Von Knoch et al., Total knee arthroplasty in a patient with chronic occlusion of the superficial femoral artery, ARCH ORTHOP, 121(3), 2001, pp. 177-179
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.