Acute arterial occlusion after total knee arthroplasty: a case report

Inomata, Kei; Sekiya, Ichiro; Otabe, Koji; Nakamura, Tomomasa; Horie, Masafumi; Koga, Hideyuki; Watanabe, Toshifumi; Muneta, Takeshi

doi:10.1002/ccr3.1075

Cited by 10 publications

(13 citation statements)

References 19 publications

(28 reference statements)

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“…After careful search and screening, 36 studies with 47 cases of arterial occlusion after knee arthroplasty in the past 35 years (1984–2018) were included in the analysis (1 from the present study) (Table S1). Demographics, predisposing conditions, perioperative details, arterial occlusion information, and prognosis are shown in Tables .…”

Section: Resultsmentioning

confidence: 99%

Diagnosis and Treatment of Arterial Occlusion after Knee Arthroplasty: The Sooner, the Better

Zeng

Xiang

Bian

et al. 2019

Orthopaedic Surgery

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Knee arthroplasty, including total knee arthroplasty (TKA) and unicondylar knee arthroplasty (UKA), is an effective procedure for patients with severe knee joint diseases. Arterial occlusion after knee arthroplasty is a rare but severe complication. However, there are few comprehensive reviews or analyses focusing on it. In this study, we presented a case of successful treatment of acute arterial occlusion of the popliteal artery after TKA by emergent balloon angioplasty, and conducted a review and analysis of published cases with this complication. After search and screening, 36 studies with 47 cases of arterial occlusion after knee arthroplasty in the past 35 years (1984–2018) were included. Among the 47 patients, there were 22 men and 25 women. The mean age was 68 years old. A total of 43 patients had primary TKA while 2 had revision surgery for TKA and 2 for UKA. For arterial occlusions, 66% presented symptoms in less than 1 day after knee surgery and 95% of the occlusion sites were around the popliteal artery. For treatment, 89% chose surgical treatment. Compared with conservative treatment, surgical treatment was more effective (P < 0.01). The patients who underwent surgical treatment less than 1 day after diagnosis had less sequelae (P < 0.05). For arterial occlusion after knee arthroplasty, we should pay attention to the perioperative risk factors and presentations, and diagnose and treat surgically at an early stage.

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Section: Resultsmentioning

confidence: 99%

Diagnosis and Treatment of Arterial Occlusion after Knee Arthroplasty: The Sooner, the Better

Zeng

Xiang

Bian

et al. 2019

Orthopaedic Surgery

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“…[ 6 ] Inomata et al describe an acute arterial occlusion after bilateral TKAs in an 80-year-old Asian female. [ 7 ] Ohira et al described an acute popliteal thrombus in a 71-year-old male with calcium pyrophosphate dihydrate crystal deposition disease. [ 8 ] Matziolis et al reported popliteal thrombus in a healthy 69-year-old female with a BMI of 35, and a 74-year-old female with a history of DVT in the contralateral leg after TKA.…”

Section: Discussionmentioning

confidence: 99%

“…Inomata et al described the risk factors in a patient with an acute popliteal artery thrombus following TKA by utilizing Virchow's triad: intravascular stasis (no motion of lower extremities under spinal anesthesia, tourniquet use), arterial damage (anterior displacement of tibia during surgery), and hypercoagulability (obesity). [ 7 ] Intravascular stasis, secondary to tourniquet use, is a potential cause for clot development. Tourniquet utilization in TKA has been long debated, and although tourniquets provide decreased perioperative blood loss, there is controversy regarding their role in DVT development.…”

Section: Discussionmentioning

confidence: 99%

Acute popliteal thrombus following total knee arthroplasty

et al. 2020

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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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“…Embolism and arterial insufficiency may develop due to tourniquet effect in patients with vascular disease and atheroma plaque in the superficial artery [8]. It has been shown that during the manipulation of the superficial femoral artery fixed during tourniquet effect, intimal damage may occur [9]. Improper placement of retractors can also cause damage by direct mechanical trauma [10].…”

Section: Intraoperative Complications 21 Vascular Injuriesmentioning

confidence: 99%

Complications after Total Knee Arthroplasty

Ayas¹,

Kalkışım²,

Köse³

et al. 2020

Knee Surgery - Reconstruction and Replacement

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Nowadays, the incidence of knee arthritis increases with the prolongation of human life and the increase in world population. As a result, total knee arthroplasty application rates increased and surgeons gained more experience. There have also been technical advances and total knee arthroplasty operations have been performed using better implants. However, despite these developments, the number and variety of complications are increasing. In addition to performing total knee arthroplasty correctly, it is now becoming more important to recognize complications that may or may develop. Variety of complications after total knee replacement; from minor skin problems to life-threatening complications. In this review article, we aimed to investigate early and late complications during and after total knee replacement surgery.

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Acute arterial occlusion after total knee arthroplasty: a case report

Cited by 10 publications

References 19 publications

Diagnosis and Treatment of Arterial Occlusion after Knee Arthroplasty: The Sooner, the Better

Diagnosis and Treatment of Arterial Occlusion after Knee Arthroplasty: The Sooner, the Better

Acute popliteal thrombus following total knee arthroplasty

Complications after Total Knee Arthroplasty

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