Iatrogenic Pseudoaneurysm After Arthroscopic Knee Procedures: A Systematic Review of Presenting Features, Injured Vessels, Management, and Outcomes.
- 1Medicine, Kansas City University of Medicine and Biosciences, Joplin, USA.
- 2College of Osteopathic Medicine, Kansas City University, Joplin, USA.
- 3Osteopathic Manipulative Medicine/Family Medicine, Kansas City University, Joplin, USA.
Abstract
Pseudoaneurysm after arthroscopic knee procedures is uncommon but clinically important because it can initially resemble routine postoperative swelling, hematoma, recurrent hemarthrosis, deep vein thrombosis, infection, or compartment syndrome. PubMed, Embase, and Scopus were searched through July 9, 2026. The original database pathway yielded 312 records and 54 included reports representing 60 patient cases. During peer-review citation audit, three additional potentially eligible reports were identified; two full texts were retrieved and included, while one report could not be retrieved and was not used for patient-level inference. The final synthesis therefore included 56 reports and 62 patient cases. Using a mutually exclusive primary-procedure classification, meniscal procedures accounted for 25/62 cases (40.3%) and anterior cruciate ligament (ACL)-related procedures for 19/62 (30.6%). The popliteal artery was the most frequent injured-vessel group (26/62, 41.9%), followed by medial/inferior genicular branches (9/62, 14.5%). Among 49 cases with an explicitly quantifiable interval to vascular diagnosis or recognition, the median was 14 days (range: 1-365 days); 13 cases had missing or non-quantifiable timing. Primary treatment was open vascular surgery in 30 cases, endovascular embolization/coiling in 14, ultrasound-guided thrombin injection in six, covered-stent or other endovascular repair in five, conservative observation in two, an unspecified vascular approach in four, and no definitive pseudoaneurysm-directed treatment was reported in one. Fasciotomy and other adjunctive procedures were coded separately. Final outcome categories were favorable recovery/resolution without persistent morbidity in 42 cases, persistent neurologic/functional morbidity or incomplete recovery in four, limited or short-term follow-up in 10, and no outcome reported in six. These frequencies describe published cases only and cannot estimate incidence, risk, or comparative treatment effectiveness. Recurrent or progressive postoperative symptoms, a pulsatile finding, neurologic change, or symptoms out of proportion to the expected course should prompt consideration of vascular imaging.
Related
- Iatrogenic pseudoaneurysm formation in the medial orbitofrontal artery following rhinoplasty and nasal osteotomy: A case report.
- Cholecystocolonic fistula with ruptured cystic artery pseudoaneurysm presenting as massive per rectal bleeding: a case report
- Ischemic Stroke as the Presenting Feature of Anterior STEMI Complicated by LV Thrombus and Pseudoaneurysm
- Bilateral Iatrogenic Pneumothorax After Acupuncture in a 26-Year-Old Woman Presenting With Cough, Pleuritic Chest Pain, and Tachycardia: A Case Report
- Non-operative management in patients with iatrogenic colorectal perforations: protocol for a systematic review
BibTeX
@article{sack2026iatrogenic,
title = {{Iatrogenic Pseudoaneurysm After Arthroscopic Knee Procedures: A Systematic Review of Presenting Features, Injured Vessels, Management, and Outcomes.}},
author = {Ethan J Sack and Max Deneroff and Zubair Mohammed and Austin Khau and Chadi Ellaham and Jared W Nichols},
journal = {Cureus},
year = {2026},
month = sep,
doi = {10.7759/cureus.116501},
url = {https://europepmc.org/article/MED/42894765},
note = {CC BY},
}
RIS
TY - JOUR
TI - Iatrogenic Pseudoaneurysm After Arthroscopic Knee Procedures: A Systematic Review of Presenting Features, Injured Vessels, Management, and Outcomes.
AU - Ethan J Sack
AU - Max Deneroff
AU - Zubair Mohammed
AU - Austin Khau
AU - Chadi Ellaham
AU - Jared W Nichols
PY - 2026
DA - 2026/09/18
JO - Cureus
DO - 10.7759/cureus.116501
UR - https://europepmc.org/article/MED/42894765
AB - Pseudoaneurysm after arthroscopic knee procedures is uncommon but clinically important because it can initially resemble routine postoperative swelling, hematoma, recurrent hemarthrosis, deep vein thrombosis, infection, or compartment syndrome. PubMed, Embase, and Scopus were searched through July 9, 2026. The original database pathway yielded 312 records and 54 included reports representing 60 patient cases. During peer-review citation audit, three additional potentially eligible reports were identified; two full texts were retrieved and included, while one report could not be retrieved and was not used for patient-level inference. The final synthesis therefore included 56 reports and 62 patient cases. Using a mutually exclusive primary-procedure classification, meniscal procedures accounted for 25/62 cases (40.3%) and anterior cruciate ligament (ACL)-related procedures for 19/62 (30.6%). The popliteal artery was the most frequent injured-vessel group (26/62, 41.9%), followed by medial/inferior genicular branches (9/62, 14.5%). Among 49 cases with an explicitly quantifiable interval to vascular diagnosis or recognition, the median was 14 days (range: 1-365 days); 13 cases had missing or non-quantifiable timing. Primary treatment was open vascular surgery in 30 cases, endovascular embolization/coiling in 14, ultrasound-guided thrombin injection in six, covered-stent or other endovascular repair in five, conservative observation in two, an unspecified vascular approach in four, and no definitive pseudoaneurysm-directed treatment was reported in one. Fasciotomy and other adjunctive procedures were coded separately. Final outcome categories were favorable recovery/resolution without persistent morbidity in 42 cases, persistent neurologic/functional morbidity or incomplete recovery in four, limited or short-term follow-up in 10, and no outcome reported in six. These frequencies describe published cases only and cannot estimate incidence, risk, or comparative treatment effectiveness. Recurrent or progressive postoperative symptoms, a pulsatile finding, neurologic change, or symptoms out of proportion to the expected course should prompt consideration of vascular imaging.
SN - 2168-8184
ER -