Pseudoaneurysm as a complication of ankle arthroscopy

Abstract

We present a case of a pseudoaneurysm of the anterior tibial artery following ankle arthroscopy with synovectomy, an extremely rare complication when standard anteromedial and anterolateral portals are used. The patient was diagnosed and treated with appropriate interventions which led to an uneventful recovery. Nevertheless, the potential sequelae of delayed diagnosis or misdiagnosis of the complication are dangerous; therefore, a high index of suspicion for a pseudoaneurysm must be maintained in the postoperative period.

Keywords: Ankle arthroscopy; anterior tibial artery; pseudoaneurysm.

Figure 1

(a) Weight-bearing anteroposterior and (b) lateral radiograph of the right ankle demonstrating an anterior ankle osteophyte with medial talar dome sclerosis, suggestive of a medial talar dome osteochondral defect

Figure 2

(a, b) Sagittal and (c) coronal CT scan of the right ankle showing osteophytes, a large medial talar dome osteochondral defect, and multiple loose bodies

Figure 3

Sagittal MRI of the right ankle confirming the diagnosis of a pseudoaneurysm arising from the anterior tibial artery as it crossed the ankle joint

Figure 4

Arteriogram of the right lower extremity confirming the diagnosis of a pseudoaneurysm arising from the anterior tibial artery as it crossed the ankle joint