Late Presentation of a Mycotic Popliteal Artery Pseudoaneurysm in the Setting of a Revised Total Knee Arthroplasty Complicated by Both Prior Infection and Periprosthetic Fracture: A Case Report

Behnke, Nicole M.; Cui, Quanjun; Orndorff, Douglas

doi:10.1016/j.avsg.2007.01.009

Cited by 8 publications

(10 citation statements)

References 19 publications

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“…These facts indicate the possibility that arterial injury had been formed by surgical procedures of the previous surgeries, rub and push of cement spacer, and so on. Behnke et al reported that, in the setting of a knee arthroplasty with infection, the risk of arterial events is increased [ 9 ], which supports our hypothesis. In the second revision TKA at our hospital, a 1200 mL hemorrhage was observed after tourniquet release; after the femoral-artery-to-posterior-tibial-artery bypass was completed, extravasation of contrast medium was observed in the distal part of the obstruction, which was speculated to be the injured part.…”

Section: Discussionsupporting

confidence: 89%

“…Arterial complications after TKA are relatively rare, with a reported rate of 0.033%–0.17% in large patient populations [ 7 , 8 ]. In an arthroplasty with complications such as revision, fracture, and infection, the risk of arterial events is increased [ 9 ]. Acute arterial occlusions are serious and can lead to amputation if inadequately treated.…”

Section: Introductionmentioning

confidence: 99%

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Acute Popliteal Artery Occlusion after Revision Total Knee Arthroplasty

Tsujimoto

Matsumoto

Takayama

et al. 2015

Case Reports in Orthopedics

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Acute arterial occlusions are a rare complication of total knee arthroplasty (TKA). However, in revision TKA, the risk of such complications is higher and these complications can lead to amputation if not adequately treated. We describe a case of acute popliteal artery occlusion 4 hours after second revision TKA in a patient with a history of several surgical procedures because of periprosthetic infection at a previous hospital. Revascularization was achieved via bypass grafting and amputation was narrowly avoided despite time lag after symptom onset to revascularization. In this case, it was possible that the arterial disease that accompanied the vascular endothelium injury such as pseudoaneurysm had existed since the previous surgery at another hospital and was destroyed by the surgical procedure, which led to the formation of thrombosis and arterial occlusion. Preoperative evaluation of the arterial condition should be considered to avoid acute arterial occlusive disease, especially in patients who had several previous surgical procedures.

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Section: Discussionsupporting

confidence: 89%

Section: Introductionmentioning

confidence: 99%

Acute Popliteal Artery Occlusion after Revision Total Knee Arthroplasty

Tsujimoto

Matsumoto

Takayama

et al. 2015

Case Reports in Orthopedics

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“…There have been reports of successful treatment of these popliteal pseudoaneurysms with endovascular stenting. Endovascular treatment involves placement of a covered stent across the defect in the popliteal artery 113–16. Though no long patient series is available, evidence suggests that endovascular treatment is safe and durable as a treatment modality in the treatment of traumatic popliteal artery pseudoaneurysms and can be performed with an acceptable morbidity rate.…”

Section: Discussionmentioning

confidence: 99%

Posttraumatic pseudoaneurysm of popliteal artery following total knee arthroplasty

Agarwala

Mohrir

Dotivala

2013

IJOO

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We report a case of posttraumatic false aneurysm of popliteal artery after a total knee arthroplasty in an 82-year-old woman. This case is characterized by the distinct history of trauma to the popliteal fossa in the immediate postoperative period and the location of false aneurysm. In addition, the clinical symptoms were similar to those of deep vein thrombosis. The ultrasonographic examination and computed tomography (CT) angiography confirmed the diagnosis on 6th day after the surgery. Ultrasonographic examination 1 day later revealed no increase in the size of false aneurysm. She was treated with open surgical repair. Presenting the difficulty in the diagnosis, unusual location, etiology, and its management is the intention of this case report.

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“…Reactivation due to the continuous bacterial residence after successful treatment is common. 90,180 Management is complicated when there are implant loosening and incomplete union. This will be discussed in the second part of this article (Figure 2).…”

Section: Diagnosismentioning

confidence: 99%

Infection after fracture osteosynthesis – Part I

Fang

Wong

Lau

et al. 2017

J Orthop Surg (Hong Kong)

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Bone and surgical site infections after osteosynthesis are notoriously difficult to manage and pose a tremendous burden in fracture management. In this article, we use the term osteosynthesis-associated infection (OAI) to refer to this clinical entity. While relatively few surgically treated fractures become infected, it is challenging to perform a rapid diagnosis. Optimal management strategies are complex and highly customized to each scenario and take into consideration the status of fracture union, the presence of hardware and the degree of mechanical stability. At present, a high level of relevant evidence is unavailable; most findings presented in the literature are based on laboratory work and non-randomized clinical studies. We present this overview of OAI in two parts: an examination of recent literature concerning OAI pathogenesis, diagnosis and classification and a review of treatment options.

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Late Presentation of a Mycotic Popliteal Artery Pseudoaneurysm in the Setting of a Revised Total Knee Arthroplasty Complicated by Both Prior Infection and Periprosthetic Fracture: A Case Report

Cited by 8 publications

References 19 publications

Acute Popliteal Artery Occlusion after Revision Total Knee Arthroplasty

Acute Popliteal Artery Occlusion after Revision Total Knee Arthroplasty

Posttraumatic pseudoaneurysm of popliteal artery following total knee arthroplasty

Infection after fracture osteosynthesis – Part I

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