Novotny Tomas, Vanaskova Eliska, Soukup Jan
Department of Orthopaedics, University J.E. Purkyně, Masaryk Hospital, Usti nad Labem, Czech Republic.
Arthroplast Today. 2021 Aug 9;10:171-174. doi: 10.1016/j.artd.2021.06.019. eCollection 2021 Aug.
Traumatic anterior dislocation of a total knee arthroplasty (TKA) is an extremely rare occurrence. There are only a few known cases of this type of dislocation which discuss the high risk of a neurovascular complication. This article describes a traumatic anterior dislocation of the TKA with a severe vascular lesion in a 75-year-old severely comorbid patient. Further complications led to the development of a compartment syndrome. Despite the repeated effort in performing a well-functioning anastomosis of the popliteal artery tear by the vascular surgeon, reperfusion of the lower extremity was not effective. Furthermore, multiorgan system failure due to the reperfusion syndrome evolved. This led to an above-knee amputation as a lifesaving procedure. Despite thorough intensive care therapy, the patient did not survive this complication. Presently there are no reported cases with such severe complications after the luxation of a previously well-functioning TKA leading to the death of the patient.
全膝关节置换术（TKA）创伤性前脱位极为罕见。已知的此类脱位病例仅有少数几例，这些病例讨论了神经血管并发症的高风险。本文描述了一名75岁、患有多种严重合并症的患者发生的TKA创伤性前脱位，并伴有严重的血管损伤。进一步的并发症导致了骨筋膜室综合征的发生。尽管血管外科医生多次努力对腘动脉撕裂进行功能良好的吻合，但下肢再灌注仍未成功。此外，由于再灌注综合征引发了多器官系统衰竭。这导致了为挽救生命而进行的膝上截肢。尽管进行了全面的重症监护治疗，患者仍未能从该并发症中存活下来。目前尚无报道称，先前功能良好的TKA脱位后出现如此严重的并发症并导致患者死亡的病例。
