The Effect of Total Knee Arthroplasty on Lower Limb Blood Flow

Acute arterial injury at the time of total knee replacement (TKR) is a rare occurrence. We questioned whether TKR could exacerbate preexisting atherosclerotic disease causing chronic limb ischemia. Thirty-three patients undergoing unilateral TKR had the peripheral arterial supply of both legs assessed 2 weeks before and 6 weeks after the operation using various methods. Although a statistically significant reduction in the velocity ratio was measured in the trial leg, 0.92 (0.33) as compared to the control, 1.11 (0.46) (P = .0002) this was not found to be clinically significant when the minimum popliteal artery diameter of the trial limb, 6.23 (1.32), was compared with the control, 6.28 (1.27) (P = .8246). Neither were significant reductions in arterial waveforms or ABPIs measured in the trial legs preoperatively, 0.97 (0.20), and postoperatively, 0.93 (0.27) (P = .2793). TKR does not impair the arterial supply of the limb at 6-week postoperative period.