Injury to the Anterior Tibial Artery during Bicortical Tibial Drilling in Anterior Cruciate Ligament Reconstruction

Kim, Sang Bum; Lim, Jin Woo; Seo, Jeong Gook; Ha, Jeong Ku

doi:10.4055/cios.2016.8.1.110

Cited by 4 publications

(4 citation statements)

References 9 publications

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Section: Resultsmentioning

confidence: 99%

“…Two of these were systematic reviews that investigated proximal femoral fractures 6 and total hip arthroplasty 12 , with the majority being retrospective studies and 1 questionnaire sent to vascular surgeons 22 . In addition, there were multiple case reports of arterial, nervous, and ureteric injury due to screw placement and drill bit use [24][25][26][27][28][29] 15 , electrical conductivity devices 61,62 , electromyography 63 , stimulus-evoked potential 64 , bioimpedance drills 65 , and acoustic emission-signal analysis 66 .…”

Section: Prevalence Of Iatrogenic Injury Using Power Toolsmentioning

confidence: 99%

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Power-Tool Use in Orthopaedic Surgery

et al. 2021

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Background:Power tools are an integral part of orthopaedic surgery but have the capacity to cause iatrogenic injury. With this systematic review, we aimed to investigate the prevalence of iatrogenic injury due to the use of power tools in orthopaedic surgery and to discuss the current methods that can be used to reduce injury.Methods:We performed a systematic review of English-language studies related to power tools and iatrogenic injuries using a keyword search in MEDLINE, Embase, PubMed, and Scopus databases. Exclusion criteria included injuries related to cast-saw use, temperature-induced damage, and complications not clearly related to power-tool use.Results:A total of 3,694 abstracts were retrieved, and 88 studies were included in the final analysis. Few studies and individual case reports looked directly at the prevalence of injury due to power tools. These included 2 studies looking at the frequency of vascular injury during femoral fracture fixation (0.49% and 0.2%), 2 studies investigating the frequency of vertebral artery injury during spinal surgery (0.5% and 0.08%), and 4 studies investigating vascular injury during total joint arthroplasty (1 study involving 138 vascular injuries in 124 patients, 2 studies noting 0.13% and 0.1% incidence, and 1 questionnaire sent electronically to surgeons). There are multiple methods for preventing damage during power-tool use. These include the use of robotics and simulation, specific drill settings, and real-time feedback techniques such as spectroscopy and electromyography.Conclusions:Power tools have the potential to cause iatrogenic injury to surrounding structures during orthopaedic surgery. Fortunately, the published literature suggests that the frequency of iatrogenic injury using orthopaedic power tools is low. There are multiple technologies available to reduce damage using power tools. In high-risk operations, the use of advanced technologies to reduce the chance of iatrogenic injury should be considered.Level of Evidence:Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

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Section: Resultsmentioning

confidence: 99%

Section: Prevalence Of Iatrogenic Injury Using Power Toolsmentioning

confidence: 99%

Power-Tool Use in Orthopaedic Surgery

et al. 2021

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“…In the immediate postoperative period, the arthroscopy fluid will resorb over time, and fasciotomy is rarely required 93. However, ACS has also been described following vascular injury,94 and as a result of bleeding complications 92. Some patients require multiple elective ligament reconstruction procedures as a consequence of prior traumatic knee dislocation, which is a high-energy injury often associated with vascular injury, and is associated with a relatively high (2.7%) risk of ACS 95…”

Section: Orthopedic Elective Surgery Of the Lower Limbmentioning

confidence: 99%

Regional anesthesia and acute compartment syndrome: principles for practice

Dwyer

Burns

Nauth

et al. 2021

Reg Anesth Pain Med

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Acute compartment syndrome (ACS) is a potentially reversible orthopedic surgical emergency leading to tissue ischemia and ultimately cell death. Diagnosis of ACS can be challenging, as neither clinical symptoms nor signs are sufficiently sensitive. The cardinal symptom associated with ACS is pain reported in excess of what would otherwise be expected for the underlying injury, and not reasonably managed by opioid-based analgesia. Regional anesthesia (RA) techniques are traditionally discouraged in clinical settings where the development of ACS is a concern as sensory and motor nerve blockade may mask symptoms and signs of ACS. This Education article addresses the most common trauma and elective orthopedic surgical procedures in adults with a view towards assessing their respective risk of ACS and offering suggestions regarding the suitability of RA for each type of surgery.

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“…The diagnosis was a compartment syndrome due to direct drilling injury to the anterior tibial artery and a fasciotomy was immediately performed for decompression. The pain was resolved but a debridement and excision of the necrotic extensor hallucis longus, extensor digitorum longus, and anterior tibialis muscles was required 9 days after ACL-R. 92…”

Section: Rare Vascular Injuriesmentioning

confidence: 99%

Uncommon Complications after Anterior Cruciate Ligament Reconstruction

Palazzolo

Rosso

Bonasia

et al. 2018

Joints

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Anterior cruciate ligament reconstruction (ACL-R) is a common surgical procedure, with good outcome in 75 to 97% of the cases. However, different complications have been described including infection, hemarthrosis, deep vein thrombosis (DVT), and pulmonary embolism (PE) with a rate ranging from 1 to 15%. There are few case reports in the literature describing rare complications after ACL-R and they can be divided into: (1) complications related to the fixation device (rupture, migration); (2) fractures (tibial or femoral side); (3) infections due to uncommon bacteria, mycobacterium, and mycosis; (4) rare vascular injuries; (5) nerve injuries; and (6) other rare complications. In case of fixation device rupture or migration, device removal can be easy but the diagnosis may be challenging. Patellar fracture after ACL-R may be related to harvesting and it is not uncommon. Conversely, femoral or tibial fractures are most frequently due to bone weakness related to bone tunnels. Some rare infections related to uncommon bacteria or mycosis are also described with potentially devastating joint damage. Popliteal artery injuries are uncommon in ACL-R but minor vessels damages are described with possible severe consequences for patients. Injuries to the infrapatellar branch of the saphenous nerve are not uncommon in ACL-R. However, there are few case reports also describing injuries to the saphenous nerve, the common peroneal nerve and the sciatic nerve. The aim of this paper is to review the literature describing uncommon complications after ACL-R, giving some more information about diagnosis and treatment.

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Injury to the Anterior Tibial Artery during Bicortical Tibial Drilling in Anterior Cruciate Ligament Reconstruction

Cited by 4 publications

References 9 publications

Power-Tool Use in Orthopaedic Surgery

Power-Tool Use in Orthopaedic Surgery

Regional anesthesia and acute compartment syndrome: principles for practice

Uncommon Complications after Anterior Cruciate Ligament Reconstruction

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