INTRODUCTION: We report the youngest documented patient (38 years old) to develop an acute popliteal artery thrombus following primary total knee arthroplasty (TKA). PATIENT CONCERNS: The patient presented for an elective TKA secondary to posttraumatic arthritis. Past medical history included a tibial plateau fracture, two knee arthroscopies and an elevated body mass index (37.53). A right TKA was performed with no intraoperative complications. Two hours postoperatively, the right foot was poikilothermic and lacking dorsalis pedal pulse. DIAGNOSIS: Popliteal artery thrombus confirmed by angiogram and venous duplex. INTERVENTIONS: Immediate vascular surgery consult and subsequent embolectomy. OUTCOMES: At 1 year postoperatively, the patient is doing well with no further complications. CONCLUSION: Due to the lack of significant past medical history putting this patient at risk, future research should focus on prior trauma, age, and BMI as risk factors, specifically in patients undergoing TKA.
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