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Superficial femoral artery pseudoaneurysm, compartment syndrome, and deep vein thrombosis after total knee arthroplasty.

ABSTRACT: Vascular injuries after total knee arthroplasty are highly infrequent, especially in the femoral artery. These lesions can cause severe damage. Early diagnosis is important to prevent catastrophic complications (such as loss of limb) and to offer adequate treatment. This study reports a patient with femoral artery injury of unknown etiology after total knee arthroplasty. Progressive and insidious symptoms from deep vein thrombosis to compartment syndrome made management even more challenging, requiring amputation of the extremity.

SUBMITTER: Sanchez CA

PROVIDER: S-EPMC7303499 | biostudies-literature | 2020 Jun

REPOSITORIES: biostudies-literature

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Superficial femoral artery pseudoaneurysm, compartment syndrome, and deep vein thrombosis after total knee arthroplasty.

Sánchez Carlos A CA Jara Ana B AB Mariño Jaime J

Arthroplasty today 20200317 2

Vascular injuries after total knee arthroplasty are highly infrequent, especially in the femoral artery. These lesions can cause severe damage. Early diagnosis is important to prevent catastrophic complications (such as loss of limb) and to offer adequate treatment. This study reports a patient with femoral artery injury of unknown etiology after total knee arthroplasty. Progressive and insidious symptoms from deep vein thrombosis to compartment syndrome made management even more challenging, re ...[more]

PMID: 32577468

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Project description:Background:Interest in bicompartmental knee arthroplasty (BKA) for the treatment of medial patellofemoral osteoarthritis (MPFOA) has grown in recent years because BKA offers a bone and ligament-preserving alternative to total knee arthroplasty (TKA). BKA only resurfaces the diseased compartments, while preserving proprioception and native knee kinematics. Therefore, the objective of this study is to assess knee function, perioperative morbidity, and implant survivability in patients undergoing BKA vs TKA for MPFOA. Methods:The databases MEDLINE, PUBMED, and EMBASE were systematically searched. Randomized controlled trials and nonrandomized comparative studies comparing BKA with TKA for the treatment of MPFOA were included for further analysis. The primary outcome of interest was knee function. Secondary outcomes included range of movement, operation length, intraoperative blood loss, hospital length of stay, postoperative complications, and rate of revision length. The quality of evidence was evaluated using the GRADE approach. Meta-analysis was performed by pooling the results of the selected studies when possible. Results:Six studies were selected for inclusion (4 prospective studies and 2 retrospective cohort studies). In total, 274 patients and 277 knees were included for analysis. There were no significant differences between the 2 groups at any time points in terms of knee function, length of stay, complication rate, or revision rate, when monolithic BKA designs were controlled for. BKA did result in significantly decreased intraoperative blood loss, at the expense of increased operative length compared with TKA. Conclusions:The use of modular BKA for MPFOA is comparable with TKA in terms of short-term function, complication rate, and revision rate. BKA reduces intraoperative blood losses, but it is also more technically demanding, resulting in increased operation length. The use of modular BKA has acceptable short-term outcomes, but more long-term data are needed before it can be recommended for routine use in the treatment of MPFOA. The selection of modular BKA should be determined on a patient-specific basis. Currently, there is no evidence to suggest the use of monolithic BKA designs because of their high revision and failure rate.

Dataset Information

Superficial femoral artery pseudoaneurysm, compartment syndrome, and deep vein thrombosis after total knee arthroplasty.

Publications

Superficial femoral artery pseudoaneurysm, compartment syndrome, and deep vein thrombosis after total knee arthroplasty.

Similar Datasets

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