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全膝关节置换术中腘动脉损伤:单中心经验

Popliteal Artery Injury During Total Knee Replacement: A Single-Center Experience.

作者信息

Alsaleem Mohammad, Almomatten Mohammed I, Alkhars Abdullah M, AlSaeed Mohammed, Alsakkak Ali A

机构信息

Orthopedic Surgery, Al Moosa Specialist Hospital, Al-Ahsa, SAU.

Orthopedic Surgery, King Fahad Hospital Hofuf, Al-Ahsa, SAU.

出版信息

Cureus. 2024 Oct 17;16(10):e71745. doi: 10.7759/cureus.71745. eCollection 2024 Oct.

Abstract

The popliteal arteries are rarely injured during total knee replacement. Although uncommon, these complications warrant attention because the consequences can be disastrous, with high mortality rates, amputation risk, and additional comorbidities such as foot drop, infection, and functional impairment. However, it has detrimental consequences for the patient. Avoiding such injuries starts with preoperative planning, which helps prevent injuries. Furthermore, preoperative planning prompts early recognition and facilitates immediate interventions to reduce complications. We presented the case of a 59-year-old female following up in an orthopedic outpatient clinic for advanced bilateral knee pain, which became more progressive in the past year. The patient had tried conservative treatment with minimal improvement and elected for total knee replacement. The operation was performed as standard. However, while trying to clear the posterior tissue, an accidental complete cut to the popliteal artery occurred. After that, the vascular surgeon performed direct repair of continuous anastomosis. Following that, distal pulses and capillary refill were felt by the surgeon to be intact. Finally, the operation was completed uneventfully. Later, the patient was discharged home in good condition and had no complications upon follow-up.

摘要

在全膝关节置换术中,腘动脉很少受到损伤。虽然这种情况不常见,但这些并发症值得关注,因为其后果可能是灾难性的,包括高死亡率、截肢风险以及诸如足下垂、感染和功能障碍等其他合并症。然而,这对患者有不利影响。避免此类损伤始于术前规划,这有助于预防损伤。此外,术前规划能促使早期识别并便于立即采取干预措施以减少并发症。我们介绍了一名59岁女性的病例,她因双侧膝关节晚期疼痛在骨科门诊随访,在过去一年中疼痛变得更加严重。患者尝试了保守治疗,改善甚微,于是选择进行全膝关节置换术。手术按标准进行。然而,在清理后方组织时,意外地将腘动脉完全切断。之后,血管外科医生进行了连续吻合的直接修复。随后,外科医生感觉到远端脉搏和毛细血管再充盈完好。最后,手术顺利完成。后来,患者状况良好出院,随访时未出现并发症。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1cfe/11570435/d0a4592759af/cureus-0016-00000071745-i01.jpg

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