Pseudo-aneurysm of the Anterior Tibial Artery Complicating High Tibial Osteotomy--a Case Report

The anterior recurrent branch of the anterior tibial artery is vulnerable during high tibial osteotomy. It may be injured during subperiosteal elevation of soft tissue from the lateral tibia--necessary for visualisation of the osteotomy or for placing the fixation device; or during excision of the infero-medial aspect of the fibular head--necessary to facilitate closure of the osteotomy. Recurrent bleeding from the operation site should draw attention to the possibility of a pseudo-aneurysm. Angiography helps in making an accurate diagnosis. Ligation of the feeding vessels provides effective treatment.