Arterial injury during revision total knee replacement

Metzdorf, Alexander; Jakob, R. P.; Petropoulos, P; Middleton, Robert

doi:10.1007/s001670050157

Cited by 16 publications

(14 citation statements)

References 6 publications

(6 reference statements)

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“…19 Indirect trauma is also described. 15 The popliteal artery is especially at risk during hyperextension while patellar preparation is performed and during hyperflexion.…”

Section: Discussionmentioning

confidence: 99%

Popliteal lesion due to traction during unicompartmental knee revision surgery

Kerens¹,

Boonen

Schotanus

et al. 2013

Journal of Orthopaedics

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a b s t r a c tPopliteal artery injury is a rare but known complication in knee surgery. Only one article in current literature reports that the risk increases during revision knee surgery. A new case is described in which an injury to the popliteal artery occurred during lateral unicompartmental to total knee arthroplasty revision surgery. This vascular injury occurred 5e10 cm below the tibial resection level in a healthy patient with a history of cruris fracture with plate osteosynthesis and lateral unicompartmental knee arthroplasty. This paper stresses the importance of being aware that trauma and surgery can create fibrosis in which the popliteal artery can get fixated, thus reducing the scope for safe manipulation of the knee during secondary surgery.Copyright ª 2013, Professor P K Surendran Memorial Education Foundation. Publishing Services by Reed Elsevier India Pvt. Ltd. All rights reserved. IntroductionVascular lesions of the popliteal artery are rare but have been described after total knee arthroplasty (TKA), unicompartmental knee arthroplasty (UKA), revision TKA, correction osteotomy procedures and dislocations of the knee. 1e9 Etiology can be thrombosis, direct trauma or indirect trauma. 3,6,7,10e16 Our case shows an indirect popliteal lesion 5 cm distal to the operation area in a patient during revision knee surgery and stresses the importance of meticulous surgery in order to prevent indirect trauma especially in cases in which fibrosis could be present due to prior surgery or trauma. Case reportA fifty one year old healthy female was treated for lateral compartmental osteoarthritis of the right knee in another hospital. A lateral UKA was performed. Because of complaints on the lateral side of the knee she visited us two years after primary surgery. The diagnosis of tibial component overhang was made and revision surgery was planned. j o u r n a l o f o r t h o p a e d i c s 1 0 ( 2 0 1 3 ) 3 8 e4 0

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“…19 Indirect trauma is also described. 15 The popliteal artery is especially at risk during hyperextension while patellar preparation is performed and during hyperflexion.…”

Section: Discussionmentioning

confidence: 99%

Popliteal lesion due to traction during unicompartmental knee revision surgery

Kerens¹,

Boonen

Schotanus

et al. 2013

Journal of Orthopaedics

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“…Most non-traumatic injuries to the popliteal artery are iatrogenic and may occur during total knee replacement, [1][2][3][4][5][6][7][8] high tibial osteotomy, 2,3,[5][6][7] anterior cruciate ligament reconstruction, 2,6 posterior cruciate ligament reconstruction, 2,6,9,10 and arthroscopic meniscectomy. 2,6,9 Despite the rare occurrence of complications involving the popliteal artery during such procedures, results of vessel injuries can be devastating and may also lead to malpractice litigation.…”

Section: Take-home Pointsmentioning

confidence: 99%

“…Anatomic variations of the distal popliteal artery and its significance in surgery have been well documented in the literature. [2][3][4][5][6]8,11 However, due to lack of awareness, this issue is often unintentionally disregarded. We present the case of an aberrant anterior tibial artery that was found during the review of a magnetic resonance imaging study.…”

Section: Take-home Pointsmentioning

confidence: 99%

The Aberrant Anterior Tibial Artery and its Surgical Risk

Jang

Nguyen²,

Rocky³

2018

Am J Orthop

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Vascular injury to the popliteal artery during knee surgery is uncommon, but it has significant consequences not only for the patient but also to the surgeon since it poses the threat of malpractice litigation. The vascular anatomy of the lower extremity is variable especially when it involves both the popliteal artery and its branches. An aberrant vascular course may increase the risk of iatrogenic vascular injury during surgery. Careful preoperative planning with advanced imaging can decrease the risk of a devastating vascular injury.

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“…Further, in preparation of this article, we encountered a case report of serious hemorrhage during revision total knee arthroplasty resulting from unawareness of the presence of an aberrant anterior tibial artery. 18 Preoperative arteriography or ultrasonography has been recommended to determine the presence of this variant. 18 This anatomical variation of the anterior tibial artery has been described previously in the anatomic and radiographic literature, but to our knowledge, the appearance of the aberrant anterior tibial artery on magnetic resonance (MR) imaging has not been previously described.…”

mentioning

confidence: 99%

“…18 Preoperative arteriography or ultrasonography has been recommended to determine the presence of this variant. 18 This anatomical variation of the anterior tibial artery has been described previously in the anatomic and radiographic literature, but to our knowledge, the appearance of the aberrant anterior tibial artery on magnetic resonance (MR) imaging has not been previously described. Our purpose was to measure the prevalence of this anatomic variant and describe its appearance on MR images.…”

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confidence: 99%

The Aberrant Anterior Tibial Artery

et al. 2008

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The anatomy suggests the aberrant anterior tibial artery may be at greater risk of injury in orthopaedic procedures such as high tibial osteotomy, revision total knee arthroplasty, lateral meniscal repair, posterior cruciate ligament reconstruction, and screw fixation for tibial tubercle osteotomy. Careful inspection of preoperative magnetic resonance imaging studies may alert the surgeon to the presence of this anatomical variant.

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Arterial injury during revision total knee replacement

Abstract: A case of an anatomical variation of the arterial vessels in the popliteal fossa, leading to a vascular transection during a total knee revision is presented. The authors believe this complication should be considered in all cases of knee revision surgery.

Cited by 16 publications

References 6 publications

Popliteal lesion due to traction during unicompartmental knee revision surgery

Popliteal lesion due to traction during unicompartmental knee revision surgery

The Aberrant Anterior Tibial Artery and its Surgical Risk

The Aberrant Anterior Tibial Artery

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