Arterial complications after knee arthroplasty: 4 cases and a review of the literature.

We reviewed 40 cases of arterial complications after total knee replacement from the literature and report 4 of our own cases. The incidence is low (0.03%-0.2%), but the prognosis is poor, with death or amputation in one fourth of the cases. Preexisting arterial insufficiency, absent pedal pulses, arterial calcification on plane radiographs, femoro- popliteal/distal grafts are all predisposing factors. Therefore, preoperative risk factor evaluation as well as rapid and adequate handling in case of bleeding and/or ischemic complications pre- and postoperatively are crucial. Cooperation with a vascular surgeon is also essential.