Superficial Femoral Artery Pseudoaneurysm After Intra-articular Adductor Canal Pain Catheter Placement for Total Knee Arthroplasty

Vascular injury following total knee arthroplasty (TKA) is a rare complication. The authors present a case of superficial femoral artery aneurysm in a 60-year-old man following elective TKA in the setting of intra-articular On-Q*(Avanos Medical) pain catheter placement into the adductor canal for postoperative pain control. This is the second reported case of pseudoaneurysm secondary to adductor canal block. The patient presented on postoperative day 8 with thigh swelling, ecchymosis, and pain. The pseudoaneurysm was subsequently diagnosed and successfully stented after selective catheterization. The patient was discharged the next day. This case highlights the importance for a high index of suspicion in patients presenting with acute swelling in the postoperative period. If identified in a timely fashion, treatment with stenting or selective catheter embolization can successfully treat this issue and help avoid further complications.