Kirschner S, Konrad T, Weil E J, Bühler M
Orthopädische Klinik König-Ludwig-Haus, Julius-Maximilians-Universität Würzburg.
Orthopade. 2004 Jul;33(7):841-5. doi: 10.1007/s00132-004-0638-z.
Arterial complications after total knee arthroplasty are rare. If the formation of a false aneurysm does occur, it usually affects the popliteal artery. We report the case of an 77 year old female with a false aneurysm of the lateral superior genicular artery. The patient was suffering from gonarthrosis and received a duocondylar knee replacement without resurfacing of the patella. Postoperatively, she reported anterior knee pain and a revision of the joint with lateral release was carried out. In the third postoperative week, a painful swelling in the lateral and superior aspect of the knee occurred. A scintigraphic investigation with enrichment in the early period was misinterpreted as infection. Ultrasonographic and angiographic investigations gave the right diagnosis of a false aneurysm. In the same angiographic investigation, the aneurysm could be cured by coil embolisation. The interval between the operation leading to the problem and the formation of the aneurysm, as well as the low incidence of this complication, made it hard to diagnose. Ultrasonographic and angiographic examinations allow for proper diagnosis in cases of unclear painful swellings. When dealing with an arterial complication following total knee arthroplasty, a specialized radiologist or vascular surgeon should be consulted immediately.
全膝关节置换术后的动脉并发症较为罕见。如果确实发生假性动脉瘤形成，通常会累及腘动脉。我们报告一例77岁女性患者，其膝上外侧动脉出现假性动脉瘤。该患者患有膝关节病，接受了双髁膝关节置换术，未进行髌骨表面置换。术后，她诉说膝关节前部疼痛，遂对关节进行了外侧松解翻修术。术后第三周，膝关节外侧和上方出现疼痛性肿胀。早期显像检查示有强化，被误诊为感染。超声和血管造影检查给出了假性动脉瘤的正确诊断。在同一次血管造影检查中，通过弹簧圈栓塞治愈了动脉瘤。导致问题的手术与动脉瘤形成之间的间隔时间，以及该并发症的低发生率，使得诊断困难。超声和血管造影检查有助于对不明原因的疼痛性肿胀病例进行正确诊断。处理全膝关节置换术后的动脉并发症时，应立即咨询专业放射科医生或血管外科医生。
