Popliteal Artery Injury Associated With Total Knee Arthroplasty: Trends, Costs and Risk Factors

Ko, Laura J. Matsen; DeHart, Matthew L.; Yoo, Jung U.; Huff, Thomas W.

doi:10.1016/j.arth.2014.01.007

Cited by 41 publications

(36 citation statements)

References 14 publications

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“…As the commonly accepted Virchow's triad [10] indicates, the presumable risk factors of acute arterial thrombosis after TKA are intravascular stasis (no motion under lumbar anesthesia, tourniquet, an elastic bandage soon after the operation), damage of arterial endothelium (hypertension, compression by tibial anterior dislocation during operation, fragile arteriosclerotic plaque in vascular endothelium), and hypercoagulopathy (history of cancer and hormonal therapy) [11]. In this case, all three risk factors did exist; therefore, a preoperative vascular study should be performed for the index patient.…”

Section: Discussionmentioning

confidence: 99%

Acute arterial occlusion after total knee arthroplasty: a case report

Inomata

Sekiya

Otabe

et al. 2017

Clinical Case Reports

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Section: Discussionmentioning

confidence: 99%

Acute arterial occlusion after total knee arthroplasty: a case report

Inomata

Sekiya

Otabe

et al. 2017

Clinical Case Reports

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“…Development of a pseudoaneurysm during TKA is rare but can significantly lengthen the hospital stay and increase hospital costs. It may also lead to serious complications such as knee stiffness, amputation, or death [6]. Few reports to date have described pseudoaneurysms arising from the ATA in association with TKA, perhaps because the ATA usually arises from the popliteal artery lower than the level of the tibial bone cut.…”

Section: Discussionmentioning

confidence: 99%

“…The risk of arterial injury after revision TKA is twice that after a primary procedure because blood vessels may be encased by fibrous scar tissue, rendering them more vulnerable to indirect or direct injury [8, 16]. Other risk factors include weight loss, renal failure, coagulopathy, and metastatic cancer [6]. …”

Section: Discussionmentioning

confidence: 99%

Pseudoaneurysm of a high-division anterior tibial artery following primary TKA

Zhao

Liu

et al. 2017

Orthopäde

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Arterial complications following total knee arthroplasty are rare but carry a high risk of significant morbidity and mortality. Herein, the authors report a case of pseudoaneurysm in a branch of a high-division anterior tibial artery caused by laceration by the retractor following primary total knee arthroplasty in a 72-year-old woman. The patient presented with an unexplained hematoma and an enlarging swelling, with pallor and acute hemorrhage on the first postoperative day. The diagnosis was confirmed by arteriography and the patient was successfully treated using endovascular embolization without long-term complications. Because of the high risk of progression to a potentially limb- or life-threatening condition, it is important to discuss the risk factors for this complication, as well as its early diagnosis and treatment methods.Electronic supplementary materialThe online version of this article (doi: 10.1007/s00132-016-3373-3) contains two videos on diagnosis and treatment of the pseudoaneurysm. The article and the supplementary material are available in the electronic archive at http://www.springermedizin.de/der-orthopaede.

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“…Two surveys of the United States National Inpatient Sample found that 0.003% to 0.057% of TKA procedures were complicated by injury to the popliteal artery that resulted in increased cost, length of stay, and mortality. 7,8 Rapid identification and treatment of iatrogenic popliteal artery injury has been shown to lead to better outcomes compared with delayed identification or definitive repair, and more effective methods are needed to detect and treat these injuries. 9 Knee positioning was believed to be an effective method to avoid accidental injury to the popliteal artery.…”

Section: Discussionmentioning

confidence: 99%

Arteriovenous Fistula Formation After Intra-articular Injection Following Total Joint Arthroplasty

Post¹,

Ong²,

Orozco³

2016

Orthopedics

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Intra-articular joint capsule injection is a common method used to control postoperative pain as a result of primary total knee arthroplasty (TKA). It is generally considered a safe practice and is highly effective in reducing the need for postoperative opioid administration as well as decreasing recovery time through early mobilization. However, any injection into the posterior knee space has the potential to injure the vascular structures surrounding the knee. Iatrogenic formation of an arteriovenous fistula is a rare complication after TKA, and there are no reported cases of arteriovenous fistula formation as a direct result of intra-articular injection. This case report describes this complication that occurred several days after TKA. The patient had acute pain and swelling in the treated leg. An arteriovenous fistula of the popliteal artery and vein was identified with bilateral Doppler ultrasound and confirmed by angiogram. The most likely inciting event for the formation of the arteriovenous fistula was intra-articular injection of bupivacaine, which likely pierced the popliteal artery and vein, allowing the formation of the patent channel. The patient was treated successfully with stent placement through interventional radiology. Orthopedic surgeons performing intra-articular injections of the knee should refamiliarize themselves with the anatomy and location of the popliteal artery, use smaller-gauge needles, and aspirate the syringe before the injection to decrease the risk of iatrogenic damage to the vasculature or fistula formation. [Orthopedics.2016; 39(5):e976-e979.].

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Popliteal Artery Injury Associated With Total Knee Arthroplasty: Trends, Costs and Risk Factors

Cited by 41 publications

References 14 publications

Acute arterial occlusion after total knee arthroplasty: a case report

Acute arterial occlusion after total knee arthroplasty: a case report

Pseudoaneurysm of a high-division anterior tibial artery following primary TKA

Arteriovenous Fistula Formation After Intra-articular Injection Following Total Joint Arthroplasty

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