ORTHOPEDIC AREA   

Medicina dello Sport 2008 March;61(1):65-70

Copyright © 2008 EDIZIONI MINERVA MEDICA

language: English, Italian

Pseudoaneurysm in a segmental branch of the posterior tibial artery following knee ligament reconstruction in a patient with favism

Buda R., Mosca M., Di Caprio F., Ruffilli A., Rossi G., Giannini S.

Rizzoli Orthopaedic Institute, University of Bologna, Bologna, Italy

Various reports of vascular damage related to arthroscopic ligament surgery of the knee have been written. The present case regards a patient with favism, who underwent anterior cruciate ligament reconstruction with hamstrings and posterior cruciate ligament reconstruction with an allogenic tendon graft. Five days after surgery the patient came back with significant anemia. The angiographic study demonstrated a small pseudoaneurysm on a medial segmental branch of the posterior tibial artery. The patient underwent vessel embolization and then he had a slow gradual increase in the haemoglobin levels over time. At last follow-up, three months after surgery, the patient had a full recovery. In conclusion, vascular damage in the proximal antero-medial tibial exposure is likely to occur frequently, but significant bleeding is rare because arterial complete sectioning results in vessel retraction and little bleeding. Favism could be considered a promoting factor for anemization. Embolization is to be considered an effective, fast and little invasive procedure for closure of defects in small calibre vessels.