Pseudoaneurysm after total knee arthroplasty: imaging findings in 7 patients.

Objective: To describe the clinical presentation of arterial pseudoaneurysms following total knee arthroplasty (TKA) and their diagnostic imaging features on ultrasound and magnetic resonance angiography (MRA) in 7 patients.Materials and Methods: A search of our radiology report database from 2007 t...

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Publicado en:Skeletal Radiology Vol. 48; no. 5; pp. 699 - 707
Autores principales: Daniels, Steven P., Sneag, Darryl B., Berkowitz, Jennifer L., Trost, David, Endo, Yoshimi
Formato: case study Journal Article
Publicado: Springer Nature May2019
Acceso en línea:Ver este registro en EBSCOhost
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      pub: Springer Nature
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        atl: Pseudoaneurysm after total knee arthroplasty: imaging findings in 7 patients.
      aug:
        au:
          Daniels, Steven P.
          Sneag, Darryl B.
          Berkowitz, Jennifer L.
          Trost, David
          Endo, Yoshimi
        affil: Department of Radiology, New York Presbyterian Hospital-Weill Cornell Medical Center, Box 141, 525 East 68th Street, 10065, New York, NY, USA
      sug:
        subj:
          Aneurysm, False
          Postoperative Complications
          Arthroplasty, Replacement, Knee
          Magnetic Resonance Angiography Methods
          Ultrasonography Methods
          Aged
          Middle Age
          Hemarthrosis
          Male
          Arthritis Impact Measurement Scales
          Scales
          Aged: 65+ years
          Middle Aged: 45-64 years
          Male
      ab: Objective: To describe the clinical presentation of arterial pseudoaneurysms following total knee arthroplasty (TKA) and their diagnostic imaging features on ultrasound and magnetic resonance angiography (MRA) in 7 patients.Materials and Methods: A search of our radiology report database from 2007 to 2017 yielded 7 patients with a pseudoaneurysm diagnosed by imaging after TKA. Clinical notes and imaging were reviewed.Results: All 7 patients were male and ranged in age from 53 to 68 (mean 61) years. All patients presented with a painful swollen knee and hemarthrosis within the first month following surgery. Five patients presented after primary TKA. One patient presented after explantation for septic arthritis and another after partial synovectomy for septic arthritis without explantation. Ultrasound identified the pseudoaneurysm as a hypoechoic or hyperechoic mass with a "yin-yang" appearance of turbulent arterial flow and associated complex joint effusion. On MRA, the pseudoaneurysm was a mass next to a parent artery showing avid contrast enhancement in the arterial phase that persisted into the venous phase and washed out in the late venous phase. Six pseudoaneurysms arose from lateral geniculate arteries and 1 from a medial geniculate artery. There were no popliteal artery pseudoaneurysms. Five patients were treated endovascularly, 1 patient thrombosed without intervention, and 1 patient was treated with open surgery.Conclusion: Pseudoaneurysm is a potential source of a painful swollen knee with hemarthrosis or a drop in hematocrit after TKA and can be identified with either ultrasound or MRA.
      pubtype: Academic Journal
      doctype:
        case study
        Journal Article
      ougenre: Article
    language: English
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