Popliteal artery thrombosis following total knee arthroplasty managed successfully with percutaneous intervention

Mathew, Anoop; Abraham, Biju; Fischer, Ludolph; Punnoose, Eapen

doi:10.1136/bcr-2014-206936

Cited by 5 publications

(3 citation statements)

References 12 publications

(13 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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“…3,5,6,9,10,21 Majority of the studies are case reports of various clinical scenarios and their treatment. 1,2,4,12,21,22 An association between the outcome and time to revascularization is well established in the literature. [5][6][7][9][10][11] Vascular injuries detected during or immediately after the surgery had good functional outcomes.…”

Section: Introductionmentioning

confidence: 98%

Vascular injuries associated with total knee arthroplasty

Hulse

Naik²,

Dilip³

et al. 2022

Int J Res Orthop

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<div class="Section1"><p class="abstract">Iatrogenic vascular injuries are rare but potentially devastating complications of total knee arthroplasty (TKA). This retrospective study analyzes vascular injuries associated with total knee arthroplasties in an urban, tertiary level referral hospital between 01 April 2010 to 31 March 2020 consisting of 6548 TKAs. Six patients sustained vascular injuries which included five primary, and one revision TKAs. Three patients were bilateral, and two were unilateral primary TKAs. The mean age-adjusted Charlson’s comorbidity index was two (range 1-3). Only two injuries were recognized intraoperatively. They underwent successful vascular repair. The third patient was diagnosed and underwent a vascular repair on the first postoperative day but experienced a permanent foot drop. Two other patients underwent thrombectomy on the fifth postoperative day; one required above-knee amputation, and the other continued to suffer from vascular claudication and paraesthesia. Another patient developed a pseudoaneurysm, which was identified and repaired five months after the primary TKA. The site of vascular injury was popliteal artery in five and superficial femoral artery in one patient. The mechanism of injury was a direct laceration in three, posterior Hohman's retractor in one, the effect of tourniquet on calcified vessels in one, and unknown in one patient. Early recognition was the only factor that significantly altered the functional outcome and limb salvage. Bilateral simultaneous total knee arthroplasties had no higher risks. A mandatory institutional protocol to recognize the early signs of vascular injuries is necessary for successful vascular repair.</p></div>

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“… 3 Approximately 46 cases have been reported in the orthopedic literature until 2015. 1 , 2 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 Nonetheless, the infrequency of these complications may make the diagnosis and treatment extremely challenging to surgeons, and limb-threatening ischemia may occur subsequently. 3 , 4 We report a case of acute vascular occlusion in the midpiece of femoral artery following TKA while aggressive thrombolysis and thrombectomy could not restore arterial circulation of the lower limb, and discuss the possible etiology causes.…”

Section: Introductionmentioning

confidence: 99%

Acute arterial occlusion in the midpiece of femoral artery following total knee arthroplasty: Report of one case

Yang

2016

Chinese Journal of Traumatology

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Acute arterial occlusion is a rare complication following total knee arthroplasty (TKA). The incidence as reported previously is from 0.03% to 0.17%; however, the sequelae can be disastrous because of its potential threat to limb loss. We report a case of acute arterial occlusion in the midpiece of femoral artery following TKA occurred 40 min postoperatively. The occlusion site existed at the midpiece of femoral artery is uncommon. Arterial circulation of the lower limb could not be restored by the thrombolysis and thrombectomy treatments performed within 11 h after TKA. In the end, amputation had to be carried out. In the treatment of acute arterial occlusion following TKA with a tourniquet, it is important to fully consider that arteriosclerosis may induce atheromatous plaque disruption, which might be the reason for acute arterial occlusion.

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Popliteal artery thrombosis following total knee arthroplasty managed successfully with percutaneous intervention

Cited by 5 publications

References 12 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

Vascular injuries associated with total knee arthroplasty

Acute arterial occlusion in the midpiece of femoral artery following total knee arthroplasty: Report of one case

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