Department of Orthopedic Surgery, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Beijing, China.
Department of Vascular Surgery, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Beijing, China.
Orthop Surg. 2019 Jun;11(3):366-372. doi: 10.1111/os.12494.
Knee arthroplasty, including total knee arthroplasty (TKA) and unicondylar knee arthroplasty (UKA), is an effective procedure for patients with severe knee joint diseases. Arterial occlusion after knee arthroplasty is a rare but severe complication. However, there are few comprehensive reviews or analyses focusing on it. In this study, we presented a case of successful treatment of acute arterial occlusion of the popliteal artery after TKA by emergent balloon angioplasty, and conducted a review and analysis of published cases with this complication. After search and screening, 36 studies with 47 cases of arterial occlusion after knee arthroplasty in the past 35 years (1984-2018) were included. Among the 47 patients, there were 22 men and 25 women. The mean age was 68 years old. A total of 43 patients had primary TKA while 2 had revision surgery for TKA and 2 for UKA. For arterial occlusions, 66% presented symptoms in less than 1 day after knee surgery and 95% of the occlusion sites were around the popliteal artery. For treatment, 89% chose surgical treatment. Compared with conservative treatment, surgical treatment was more effective (P < 0.01). The patients who underwent surgical treatment less than 1 day after diagnosis had less sequelae (P < 0.05). For arterial occlusion after knee arthroplasty, we should pay attention to the perioperative risk factors and presentations, and diagnose and treat surgically at an early stage.
膝关节置换术，包括全膝关节置换术（TKA）和单髁膝关节置换术（UKA），是治疗严重膝关节疾病患者的有效方法。膝关节置换术后动脉闭塞是一种罕见但严重的并发症。然而，很少有全面的综述或分析关注这一问题。在本研究中，我们报告了一例 TKA 后急性腘动脉闭塞成功治疗的病例，并对该并发症的已发表病例进行了回顾和分析。经过搜索和筛选，在过去 35 年（1984-2018 年）中，有 36 项研究共纳入了 47 例膝关节置换术后动脉闭塞病例。47 例患者中，男性 22 例，女性 25 例。平均年龄为 68 岁。共有 43 例患者行初次 TKA，2 例因 TKA 行翻修手术，2 例因 UKA 行翻修手术。对于动脉闭塞，66%的患者在膝关节手术后 1 天内出现症状，95%的闭塞部位在腘动脉周围。对于治疗，89%的患者选择手术治疗。与保守治疗相比，手术治疗更有效（P<0.01）。诊断后 1 天内接受手术治疗的患者后遗症较少（P<0.05）。对于膝关节置换术后动脉闭塞，我们应注意围手术期的危险因素和表现，并尽早进行诊断和手术治疗。
