Popliteal Artery Pseudoaneurysm with Secondary Chronic Common Peroneal Nerve Neuropathy and Foot Drop after Total Knee Replacement

Ghazala, Christopher George; Elsaid, Tarek; Mudawi, Ahmed

doi:10.1016/j.avsg.2015.04.082

Cited by 10 publications

(4 citation statements)

References 6 publications

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“…[ 3 ]. There have even been cases described in which the presence of the pseudoaneurysm led to a permanent foot drop, caused by compression on the common peroneal nerve [ 12 , 14 ]. In our patient, hypesthesia of digits 3 to 5 of the right foot and heel persisted at the most recent follow-up (8 months).…”

Section: Discussionmentioning

confidence: 99%

Pseudoaneurysm of the Popliteal Artery After Revision Knee Arthroplasty

Schermer¹,

Berger

Stomp

et al. 2022

Arthroplasty Today

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Pseudoaneurysm of the popliteal artery is a rare complication of total knee arthroplasty (TKA), with a reported incidence of 0.0095% to 0.088%. We describe the case of a 66-year-old female who underwent conversion of unicompartmental knee arthroplasty (2014) to a TKA because of instability symptoms. A pseudoaneurysm of the popliteal artery was found postoperatively on ultrasound performed because of persistent symptoms of pain and tightness of her calf and hypesthesia of digits 3 to 5. She was treated endovascularly with placement of a covered stent. At the most recent follow-up (8 months after surgery), the complaints of hypesthesia persist. A pseudoaneurysm of the popliteal artery is a rare, yet welldescribed, complication of TKA often found coincidentally on Duplex ultrasound usually performed to rule out a deep venous thrombosis. Prompt diagnosis is of great importance given the potential to developing compartment syndrome or irreversible neurological deficits.

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Section: Discussionmentioning

confidence: 99%

Pseudoaneurysm of the Popliteal Artery After Revision Knee Arthroplasty

Schermer¹,

Berger

Stomp

et al. 2022

Arthroplasty Today

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“…Postoperatively, medical therapy for neuropathy is also important. Some works 2 , 8 revealed that the chronic compressive neuropathy in PAA is irreversible. In our case, the OSR was immediately performed after foot drop occurred, and glucocorticoid was given perioperatively.…”

Section: Discussionmentioning

confidence: 99%

Successful surgical management of a ruptured popliteal artery aneurysm with acute common peroneal nerve neuropathy: A rare case

2020

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Objectives Ruptured popliteal artery aneurysm is a rare entity, which can cause severe nerve neuropathy. Open surgical repair is the preferred treatment for ruptured popliteal artery aneurysm but may aggravate nerve injuries or lead to postoperative aneurysm enlargement. The current surgical techniques for ruptured popliteal artery aneurysm have some deficiencies. Methods We present the case of a 78-year-old woman with sudden swelling of left knee joint and left foot drop, which was caused by the ruptured popliteal artery aneurysm and its compression. A modified open surgical repair was applied in our case, and glucocorticoid therapy was given perioperatively. Results The motor function of left lower limb had rapidly recovered after operation, and six-month follow-up showed patency of prosthetic vessel and significant shrinkage of aneurysm sac. Conclusions Our modified open surgical repair can relieve the compression and prevent possible “type II endoleak” without dissecting in popliteal fossa. Acute common peroneal nerve neuropathy and foot drop are reversible with immediate removal of compression and glucocorticoid therapy for patients with ruptured popliteal artery aneurysm.

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“…From a scan of literature, no other report of such an etiology of foot drop was found. Foot drop has been reported to occur after total knee prosthesis due to tight bandage application, fibula head avulsion, apparatus making inappropriate excessive pressure, vascular injuries and compartment syndrome [17,21,31,32,33]. In 2 of the current study cases, pneumatic tourniquet was used for an appropriate time at an appropriate pressure and no tight bandaging was used postoperatively.…”

Section: Discussionmentioning

confidence: 99%

“…These include diseases affecting the central nervous system, trauma, diseases affecting the peripheral nervous system and diseases or trauma affecting the muscle and tendon. Many reasons have been reported such as ganglion cyst in the proximal tibiofibular joint [3], motor cortex contusion [4], long-term lead intoxication [5], tight application of compression bandage [6,7], after lateral decubitus position [8] following dislocation reduction after total hip arthroplasty and gluteal haematoma [9,10], a complication of disc surgery [11], peripheral nerve entrapment [12,13], poorly administered injections (14], sciatic nerve pressure, piriformis syndrome [15], knee dislocations [16], following spinal and spinoepidural anaesthesia [17], paraspinal abscess [18], myopathies [19], neuropathic demyelinisation, hereditary neuropathies [20], popliteal artery aneurism [21], stroke [22,23], neuromuscular diseases [24,25], degenerative lumbar spinal diseases [26], gluteal compartment syndrome [27], decompression in burns [28], parasitic diseases such as neuro schistomiasis [29], after lower extremity compartment syndrome [30], and after total knee prosthesis [31].…”

Section: Introductionmentioning

confidence: 99%

New and unusual causes of foot drop

Aldemir¹,

Duygun²

2017

Med-Science

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Several reasons for foot drop have been reported in literature. In recent years, innovations have been added associated with some current treatment methods. The study comprised 12 patients who presented with foot drop, with rarely seen or not previously encountered causes. The patients comprised 6 males and 6 females with a mean age of 41.25 years (range, 18-72 years). The etiology of the foot drop which developed in the patients was after taking the peroneus longus tendon as autograft with a tendon stripper in 2 cases, after revision total knee arthroplasty in 1 case, after primary total knee arthroplasty in 2 cases, after a fall while playing football in 1, after injection in 3, secondary to bilateral compartment syndrrome in 1, after lying in a lateral position for a long time during a kidney operation in 1 and following a burn injury in 1 case. Of the total 12 patients, transfer of the tibialis posterior tendon to the anterior was applied in 4 cases. Decompression and fasciotomy was applied to 2 cases. In 3 cases, surgical tendon transfer was recommended but the patients rejected this treatment. Conservative follow-up was applied to 3 cases. The 4 patients applied with tendon transfer returned to daily activities problem-free. In the 2 cases applied with decompression and fasciotomy, full sensory and motor functions returned to normal in the 15th and 16th week. The motor and sensory functions of the 3 patients followed up conservatively returned to normal in the 14th-15th weeks. Foot drop is the result of an underlying problem rather than a disease per se. New treatment methods applied in orthopaedic surgery may cause the development of unusual foot drop. An awareness of these is necessary together with a detailed anamnesis, examination and laboratory tests to be able to determine the reason and plan treatment.

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Popliteal Artery Pseudoaneurysm with Secondary Chronic Common Peroneal Nerve Neuropathy and Foot Drop after Total Knee Replacement

Cited by 10 publications

References 6 publications

Pseudoaneurysm of the Popliteal Artery After Revision Knee Arthroplasty

Pseudoaneurysm of the Popliteal Artery After Revision Knee Arthroplasty

Successful surgical management of a ruptured popliteal artery aneurysm with acute common peroneal nerve neuropathy: A rare case

New and unusual causes of foot drop

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