Darılmaz Muhammed Furkan, Demirel Mehmet, Kendirci Alper Şükrü, Kızılkurt Taha
Istanbul University, Istanbul Faculty of Medicine, Department of Orthopedics and Traumatology, Istanbul, Turkey.
Istanbul University, Istanbul Faculty of Medicine, Department of Orthopedics and Traumatology, Istanbul, Turkey.
Int J Surg Case Rep. 2024 Jun;119:109767. doi: 10.1016/j.ijscr.2024.109767. Epub 2024 May 17.
Neurovascular compromise following primary or revision total knee arthroplasty is a rare but severe complication. To the best of our knowledge, there have been reports of pseudoaneurysm of the popliteal artery following primary and revision; however, an anterior tibial artery pseudoaneurysm with articulating spacer has not been described yet.
We introduce a rare case of anterior tibial artery pseudoaneurysm and concomitant foot drop caused by an articulating spacer in a two-stage revision for infected knee replacement. Displacement of the articular spacer was observed on knee x-rays. Hematoma and pseudoaneurysm were detected. The patient was operated on urgently, and a pseudoaneurysm originating from the anterior tibial artery was intraoperatively observed.
Vascular complications following TKA are rare but could be limb-threatening and even life-threatening. If postoperative displacement of the articulating spacer is observed with neurovascular symptoms, orthopedic surgeons should be alerted to the possibility of a pseudoaneurysm.
Although rare, anterior tibial artery pseudoaneurysm should be considered among vascular injuries in revision knee arthroplasty cases.
初次或翻修全膝关节置换术后发生神经血管损伤是一种罕见但严重的并发症。据我们所知，已有初次和翻修术后腘动脉假性动脉瘤的报道；然而，带有关节间垫片的胫前动脉假性动脉瘤尚未见描述。
我们介绍一例罕见的胫前动脉假性动脉瘤病例，该病例发生在因感染性膝关节置换进行二期翻修时，关节间垫片导致了假性动脉瘤并伴有足下垂。膝关节X线片上观察到关节间垫片移位。检测到血肿和假性动脉瘤。患者接受了紧急手术，术中观察到起源于胫前动脉的假性动脉瘤。
全膝关节置换术后的血管并发症罕见，但可能危及肢体甚至生命。如果观察到关节间垫片术后移位并伴有神经血管症状，骨科医生应警惕假性动脉瘤的可能性。
虽然罕见，但在翻修膝关节置换病例的血管损伤中应考虑胫前动脉假性动脉瘤。
