Traumatic Knee Dislocation and Popliteal Artery Injury: A Case Series

Karkos, Christos D.; Koudounas, Georgios; Giagtzidis, Ioakeim T.; Mitka, Maria-Aphroditi; Pliatsios, Ioannis; Papazoglou, Konstantinos

doi:10.1016/j.avsg.2018.01.084

Cited by 14 publications

(7 citation statements)

References 8 publications

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“…Recent case series reports from Teissier et al and Karkos et al both reported diagnosis relying on clinical findings and less selective arteriography but rather CTA and MRA according to local preferences. 44,45 Recent (systematic) reviews also support our findings and suggestions. Medina et al assessed vascular injuries after KD and the imaging modality used for detection analyzing 23 references (studies) describing 171 (19.8%) vascular injuries in 862 patients.…”

Section: Knee Dislocation Literaturesupporting

confidence: 88%

Vascular Injuries following Knee Dislocation

Stannard

Schreiner

2020

J Knee Surg

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Knee dislocations (KDs) are frequently found in high-energy impact injuries, ranging from automobile accidents to contact sports. KDs require careful examination due to the limb-threatening nature of these injuries. A key examination in any KD comprises a proper assessment of the vascular status. The risk of popliteal artery injury with a KD has varied from 7 to 40%, with more contemporary studies reporting injury in the range of 7 to 15%. The notion of mandatory emergent arteriography was challenged in the trauma literature as several small retrospective studies suggested that selective arteriography was a safe and effective treatment protocol. New imaging modalities have evolved and have found their way into trauma surgery. Computed tomography angiography and magnetic resonance angiography are two contemporary imaging modalities that have different characteristics as well as availability. Arteriography has been the gold standard and is a reliable and proven method of evaluation. However, it has a number of negative aspects that must be considered when determining the ideal imaging for a patient following KD. Besides cost savings of about more than US$500,000, conventional arteriography, which comprises the use of X-ray, arterial puncture and cannulation, and the use of contrast agents containing iodine, has got a complication rate as high as 9% and more patient discomfort compared with the new imaging modalities. This clinical practice review documents that our algorithm of clinical examination first combined with advanced imaging in cases with abnormalities documented on examination is a safe and prudent policy in treating patients following KD.

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Section: Knee Dislocation Literaturesupporting

confidence: 88%

Vascular Injuries following Knee Dislocation

Stannard

Schreiner

2020

J Knee Surg

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“…Nineteen studies including 37,087 KDs were evaluated. [12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30] The level of evidence (LOE) distribution of the studies was as follows: LOE 1 (n = 1), LOE 2 (n = 0), LOE 3 (n = 6), LOE 4 (n = 12), and LOE 5 (n = 0). Most of the studies (n = 12) were retrospective case series and most (n = 14) only included patients from their home institution (Table 2).…”

Section: Resultsmentioning

confidence: 99%

Vascular Injury After Knee Dislocation: A Meta-Analysis Update

Constantinescu

Luxenburg

Syros

et al. 2022

J Am Acad Orthop Surg

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Introduction:Multisystem injuries affecting vasculature and nerves can be detrimental sequelae of knee dislocations (KDs). The purpose of this study was to provide an update of the current literature since the conducted search used in the publication of Medina et al on May 3, 2013, to evaluate (1) the frequency of vascular and neurologic injury after KD, (2) the frequency with which surgical intervention was conducted for vascular injury in this setting, and (3) the frequency with which each imaging modality was used to detect vascular injury.Methods:A two-author screening process was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines using the MEDLINE database. Frequency of vascular injury, surgical intervention, and amputation after KD were analyzed. Diagnostic modalities used in the acute-care setting were also evaluated.Results:Nineteen articles were analyzed for a total of 37,087 KDs. Of these, 10.7% sustained vascular injuries and 19.6% sustained nerve injuries. Overall, 62.2% of patients with vascular injury underwent surgical repair and 2.2% limbs resulted in amputation. Angiography was the most frequently used diagnostic modality (91.7%).Discussion:This review updates our understanding on the clinical implications of KDs including frequency of vascular injury (10.7%), amputation (2.2%), and nerve injuries (19.6%). Compared with prior literature, there was an increased prevalence of KD1 (32.4%) and lateral KDs (80.4%). Most vascular injuries after KD undergo surgical repair (62.2%).

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“…It can occur in the form of occlusion, transection or intimal injury. It is uniquely susceptible to injury due to its ligamentous fixation and anatomical relationships to the tibia, femur and knee joint structures [2] .…”

Section: Introductionmentioning

confidence: 99%

Low energy knee dislocation with neurovascular compromise in a patient with a high body mass index

Qureshi¹,

Choudhry²

2022

Int. J. Case Rep. Orthop.

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We present a case of a 54-year-old patient with high body mass index (BMI) who presented with a traumatic knee dislocation with an associated popliteal artery occlusion after the patient's partner fell onto the affected patients' leg. This led to the patient requiring an urgent reduction in the emergency department (ED), followed by external fixation in theatre with popliteal artery bypass. This case highlights the importance of early recognition of vascular compromise and early reduction in the ED followed by relevant imaging.

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Traumatic Knee Dislocation and Popliteal Artery Injury: A Case Series

Cited by 14 publications

References 8 publications

Vascular Injuries following Knee Dislocation

Vascular Injuries following Knee Dislocation

Vascular Injury After Knee Dislocation: A Meta-Analysis Update

Low energy knee dislocation with neurovascular compromise in a patient with a high body mass index

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