Joshi Amit, Singh Nagmani, Pradhan Ishor, Basukala Bibek
Department of Orthopedics, Nepalese Army Institute of Health Sciences, Kathmandu, Nepal.
Department of Orthopedics and Traumatology, B&B Teaching Hospital, Lalitpur, Nepal.
JBJS Case Connect. 2019 Dec;9(4):e0481. doi: 10.2106/JBJS.CC.18.00481.
A 32-year-old man underwent arthroscopic anterior cruciate ligament reconstruction (ACLR) using hamstring autograft. He complained of persistent posterior knee pain in the postoperative period and at 4 weeks postsurgery developed foot drop and intense posterior knee pain. On clinicoradiological evaluation, a popliteal pseudoaneurysm (PSA) was diagnosed. The patient underwent surgical exploration, excision of the PSA, and primary repair of the popliteal artery. The foot drop recovered at 3 months post-second surgery follow-up.
Persistent posterior knee pain and popliteal fossa swelling in a patient after ACLR should raise a suspicion of popliteal PSA. Identifying these lesions early can prevent further complications such as common peroneal nerve palsy.
一名32岁男性接受了使用腘绳肌自体移植物的关节镜下前交叉韧带重建术(ACLR)。他在术后期间抱怨膝关节后部持续疼痛,术后4周出现足下垂和膝关节后部剧痛。经临床放射学评估,诊断为腘窝假性动脉瘤(PSA)。患者接受了手术探查、PSA切除及腘动脉一期修复。第二次手术后3个月随访时足下垂恢复。
ACLR术后患者出现膝关节后部持续疼痛和腘窝肿胀应怀疑腘窝PSA。早期识别这些病变可预防诸如腓总神经麻痹等进一步并发症。