Position of the popliteal artery in revision total knee arthroplasty

Karim, Mahmoud M. Abdel; Anbar, Ashraf; Keenan, Jonathan

doi:10.1007/s00402-012-1479-6

Cited by 3 publications

(3 citation statements)

References 14 publications

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“…Nevertheless, other studies have reported that flexion of the knee at 90° does not significantly increase the arterial–tibial distance than full extension, 20 and there is no reliable fall back of the popliteal artery in the knee flexion in a revision total knee situation. 21 Further studies in a primary complete knee situation will be performed. Fourth, the distance was measured using a copy and paste method of MRI acquisition.…”

Section: Discussionmentioning

confidence: 99%

Proximal Branching of the Anterior Tibial Artery From the Popliteal Artery Increases the Risk of Vascular Injury During Total Knee Arthroplasty: A Retrospective Analysis Using Preoperative Magnetic Resonance Imaging and Intraoperative Findings

Kimura¹,

Takahashi

et al. 2022

Geriatr Orthop Surg Rehabil

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Introduction Arterial injury following total knee arthroplasty (TKA) can be life-threatening. There are some anatomical variations in the popliteal artery (PA) and its branches. In most cases, the PA branches into the anterior tibial artery (ATA) and posterior tibial artery (PTA), which are usually distal to the height of tibial resection in TKA. However, some cases show that the PA branches into the ATA and PTA proximal to the height of tibial resection in TKA. This study aimed to assess the distance from the posterior cortex of the proximal tibia to the anterior wall of the PA or ATA at the height of the tibial cut line, during TKA in the distal and proximal branch groups. Methods 129 patients (6 patients in the proximal branch group and 123 patients in the distal branch group) were enrolled for this study. For prediction of the distance from the posterior cortex of the proximal tibia to the anterior wall of the PA or ATA, preoperative sagittal and coronal magnetic resonance images and postoperative radiographs were evaluated. Results The distance between the posterior cortex of the proximal tibia and the anterior wall of the PA or ATA at the height of the tibial cut line was 1.8 ± 1.1 mm in the proximal branch group and 6.1 ± 2.6 mm in the distal branch group, which was significantly closer in the proximal group (P < .05). Discussion The rate of proximal branching was 4.7%. This study clarified that the proximal branching of the ATA from PA significantly decreased the distance between the posterior cortex of the proximal tibia and the anterior wall of the artery. Conclusions The proximal branch group has a high risk for arterial injury as the artery may be close to the saw, and appropriate retraction should be performed.

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Section: Discussionmentioning

confidence: 99%

Proximal Branching of the Anterior Tibial Artery From the Popliteal Artery Increases the Risk of Vascular Injury During Total Knee Arthroplasty: A Retrospective Analysis Using Preoperative Magnetic Resonance Imaging and Intraoperative Findings

Kimura¹,

Takahashi

et al. 2022

Geriatr Orthop Surg Rehabil

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“…The incidence of popliteal artery injury in TKA is thought to be 0.03% to 0.2%. 1,2,5,7,8 Vessel injury in both high tibial osteotomy and arthroscopic surgeries (lateral meniscal repair) have also been reported. 5,6,8,10 Despite the rare occurrence of this complication, it may have devastating outcomes.…”

Section: 711-13mentioning

confidence: 99%

“…Most non-traumatic injuries to the popliteal artery are iatrogenic and may occur during total knee replacement, [1][2][3][4][5][6][7][8] high tibial osteotomy, 2,3,[5][6][7] anterior cruciate ligament reconstruction, 2,6 posterior cruciate ligament reconstruction, 2,6,9,10 and arthroscopic meniscectomy. 2,6,9 Despite the rare occurrence of complications involving the popliteal artery during such procedures, results of vessel injuries can be devastating and may also lead to malpractice litigation.…”

Section: Take-home Pointsmentioning

confidence: 99%

The Aberrant Anterior Tibial Artery and its Surgical Risk

Jang

Nguyen²,

Rocky³

2018

Am J Orthop

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Vascular injury to the popliteal artery during knee surgery is uncommon, but it has significant consequences not only for the patient but also to the surgeon since it poses the threat of malpractice litigation. The vascular anatomy of the lower extremity is variable especially when it involves both the popliteal artery and its branches. An aberrant vascular course may increase the risk of iatrogenic vascular injury during surgery. Careful preoperative planning with advanced imaging can decrease the risk of a devastating vascular injury.

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Arteriovenous Fistula Formation After Intra-articular Injection Following Total Joint Arthroplasty

Post¹,

Ong²,

Orozco³

2016

Orthopedics

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Intra-articular joint capsule injection is a common method used to control postoperative pain as a result of primary total knee arthroplasty (TKA). It is generally considered a safe practice and is highly effective in reducing the need for postoperative opioid administration as well as decreasing recovery time through early mobilization. However, any injection into the posterior knee space has the potential to injure the vascular structures surrounding the knee. Iatrogenic formation of an arteriovenous fistula is a rare complication after TKA, and there are no reported cases of arteriovenous fistula formation as a direct result of intra-articular injection. This case report describes this complication that occurred several days after TKA. The patient had acute pain and swelling in the treated leg. An arteriovenous fistula of the popliteal artery and vein was identified with bilateral Doppler ultrasound and confirmed by angiogram. The most likely inciting event for the formation of the arteriovenous fistula was intra-articular injection of bupivacaine, which likely pierced the popliteal artery and vein, allowing the formation of the patent channel. The patient was treated successfully with stent placement through interventional radiology. Orthopedic surgeons performing intra-articular injections of the knee should refamiliarize themselves with the anatomy and location of the popliteal artery, use smaller-gauge needles, and aspirate the syringe before the injection to decrease the risk of iatrogenic damage to the vasculature or fistula formation. [Orthopedics.2016; 39(5):e976-e979.].

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Position of the popliteal artery in revision total knee arthroplasty

Cited by 3 publications

References 14 publications

Proximal Branching of the Anterior Tibial Artery From the Popliteal Artery Increases the Risk of Vascular Injury During Total Knee Arthroplasty: A Retrospective Analysis Using Preoperative Magnetic Resonance Imaging and Intraoperative Findings

Proximal Branching of the Anterior Tibial Artery From the Popliteal Artery Increases the Risk of Vascular Injury During Total Knee Arthroplasty: A Retrospective Analysis Using Preoperative Magnetic Resonance Imaging and Intraoperative Findings

The Aberrant Anterior Tibial Artery and its Surgical Risk

Arteriovenous Fistula Formation After Intra-articular Injection Following Total Joint Arthroplasty

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