Tourniquet-Free Knee Arthroscopy in a Patient with Clinical Features Suggestive of Klippel–Trénaunay Syndrome: A Case Report
Year: 2026
Type: article
Study design: Case Report
Abstract: Knee arthroscopy is a minimally invasive orthopedic surgical procedure widely used for the diagnosis and treatment of various intra-articular knee pathologies, including meniscal tears, chondral lesions, and synovial disorders.[1] Pneumatic tourniquets are frequently used during arthroscopic knee surgery to improve visualization and reduce intra-articular bleeding.[2] However, tourniquet use has been associated with several potential risks, including venous stasis, muscle and nerve injury, and thromboembolic complications.[3] Chronic venous insufficiency and congenital vascular malformations are clinical conditions that may present with venous dilation, limb hypertrophy, and skin discoloration of the lower extremities.[4] Among these conditions, Klippel-Trénaunay syndrome (KTS) is a rare congenital vascular malformation characterized by the triad of capillary malformations, venous varicosities, ABSTRACT Klippel-Trénaunay syndrome (KTS) and related venous malformation disorders may complicate lower-extremity surgery because of abnormal venous circulation and the potential risks of bleeding and thromboembolic events.We report the case of a 43-year-old man with chronic left knee pain and lifelong enlargement and cyanotic discoloration of the affected lower extremity.Magnetic resonance imaging demonstrated a medial femoral condyle osteochondral lesion, a longitudinal tear of the posterior horn of the medial meniscus, a suprapatellar plica, and multiple dilated periarticular venous structures.Doppler ultrasonography showed a patent deep venous system without thrombosis but marked superficial venous dilatation and great saphenous vein reflux.Following vascular surgical evaluation, the clinical findings were considered suggestive of the KTS spectrum.Knee arthroscopy was therefore performed without pneumatic tourniquet inflation.Adequate visualization was maintained using gravity-assisted irrigation and meticulous radiofrequency hemostasis.The medial meniscal tear was repaired, the osteochondral lesion was treated with debridement and microfracture, and the suprapatellar plica was resected.No intraoperative or postoperative vascular or orthopedic complications occurred.At 6 months, the patient had regained full knee motion with substantial symptomatic improvement.This case suggests that tourniquet-free knee arthroscopy may be a feasible option for carefully selected patients with suspected venous malformations, provided appropriate preoperative vascular assessment and meticulous intraoperative hemostasis are employed.
Authors: Onur Kaya, Tahir Yavuz
Institution: Gaziantep Şehir Hastanesi
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W7204458829