Iatrogenic injury of the popliteal artery in orthopedic knee surgery: clinical results and development of a therapeutic algorithm.

Purpose: Intraoperative injury to the popliteal artery is a rare complication of orthopedic surgery, however, it can have serious consequences, including major amputation. Recommendations for a standard approach are lacking. The aim of this study was to develop an interdisciplinary therapeutic algor...

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Published in:European Journal of Trauma & Emergency Surgery Vol. 48; no. 5; pp. 4169 - 4180
Main Authors: Gosslau, Yvonne, Warm, Tobias Dominik, Foerch, Stefan, Zerwes, Sebastian, Scheurig-Muenkler, Christian, Hyhlik-Duerr, Alexander
Format: algorithm diagnostic images pictorial research tables/charts Journal Article
Published: Springer Nature Oct2022
Online Access:View this record in EBSCOhost
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      dt: Oct2022
      vid: 48
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      pub: Springer Nature
      place: New York, New York
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        10.1007/s00068-022-01961-8
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        atl: Iatrogenic injury of the popliteal artery in orthopedic knee surgery: clinical results and development of a therapeutic algorithm.
      aug:
        au:
          Gosslau, Yvonne
          Warm, Tobias Dominik
          Foerch, Stefan
          Zerwes, Sebastian
          Scheurig-Muenkler, Christian
          Hyhlik-Duerr, Alexander
        affil: Vascular Surgery, Faculty of Medicine, University of Augsburg, Stenglinstr. 2, 86156, Augsburg, Germany
      sug:
        subj:
          Iatrogenic Disease
          Popliteal Artery Injuries
          Orthopedic Care
          Knee Surgery
          Algorithms
          Blood Vessels Injuries
          Multidisciplinary Care Team
          Postoperative Complications Prevention and Control
          Retrospective Design
          Arthroplasty, Replacement, Knee
          Arthroscopy
          Osteotomy
          Hemorrhage
          Ischemia
          Aneurysm, False Surgery
          Endovascular Procedures
          Thrombectomy
          Thrombin Administration and Dosage
          Administration, Intravenous
          Embolization, Therapeutic
          Saphenous Vein
          Functional Status
          Functional Assessment
          Early Diagnosis
          Age Factors
          Human
          Male
          Female
          Data Analysis Software
          Descriptive Statistics
          Male
          Female
      ab: Purpose: Intraoperative injury to the popliteal artery is a rare complication of orthopedic surgery, however, it can have serious consequences, including major amputation. Recommendations for a standard approach are lacking. The aim of this study was to develop an interdisciplinary therapeutic algorithm to assist in complication management. Methods: From 01/11 to 12/20, 16 arterial injuries after knee surgery were analyzed in a retrospective single-center study. Four cases involved recurrent orthopedic surgery. Procedures performed included eleven total knee arthoplasties (TKA), two TKA replacements, one arthroscopy, and two high tibial osteotomies. Clinical presentation of patients was hemorrhage (n = 2), ischemia (n = 7), the combination of both (n = 4), or pseudoaneurysm formation (n = 3). Results: Ten patients underwent endovascular treatment, some as combined procedures: (stent)-PTA (n = 6), aspiration thrombectomy (n = 5), thrombin injection (n = 1), and embolization (n = 1). Six patients were treated surgically: four with bypass/interposition and one with a patch plasty and one as a hybrid procedure, respectively. Only autologous great saphenous vein was used. All extremities could be preserved. Functional impairment remained in six cases. Conclusion: Both endovascular and surgical procedures can be used to treat arterial injuries after knee surgery. Efficient standardized diagnosis and the involvement of vascular expertise are essential to prevent functional impairment or limb loss, as suggested in the algorithms.
      pubtype: Academic Journal
      doctype:
        algorithm
        diagnostic images
        pictorial
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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