Pseudoaneurysm of the superior lateral genicular artery: case report of a rare complication after total knee arthroplasty

Patient Safety in Surgery

Vaibhav Jain¹  Vijay Kumar¹  Shivanand Gamanagatti²  Rajesh Malhotra¹  Sanjay Meena¹  Pramod Saini¹ 

[1] Department of Orthopedics, All India Institute of Medical Sciences, Ansari, Nagar, New Delhi 110029, India;Department of Radiodiagnosis, All India Institute of Medical Sciences, Ansari, Nagar, New Delhi 110029, India

关键词: Embolization;    Genicular artery;    Pseudo aneurysm;    Stiff knee;    Total knee arthroplasty;   

Others  :  790310
DOI  :  10.1186/1754-9493-7-15

 received in 2013-02-20, accepted in 2013-05-15,  发布年份 2013

【 摘 要 】

Background

Pseudoaneurysm of superior lateral genicular artery following total knee arthroplasty is a rare complication and has been reported following lateral release performed for eversion of patella in a knee with tight lateral structures.

Case presentation

This report describes a case of pseudo aneurysm of superior lateral geniculate artery that developed after primary Total knee arthroplasty for a stiff knee in a 68 year old patient. Patient presented with pain and rapidly increasing swelling in early post operative period. Diagnosis was made on duplex ultrasound and confirmed by angiography. Angiographic coil embolisation of the pseudoaneurysm was performed. Since no lateral release was performed in this case, the probable mechanism was shear injury to the vessel.

Conclusion

Pseudoaneurysm of superior lateral genicular artery can occur in absence of lateral release by shear injury to an atherosclerotic vessel. Angiographic coil embolisation appears to be the best method for treating such post arthroplasty pseudoaneurysm because of less chance of infection, non interference with rehabilitation and diagnosis and treatment during same procedure.

【 授权许可】

   
2013 Saini et al.; licensee BioMed Central Ltd.

【 图 表 】

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【 参考文献 】

• [1]Smith DE, McGraw RW, Taylor DC: Arterial complications and total knee arthroplasty. J Am Acad Orthop Surg 2001, 9:253-257.
• [2]O'Connor JV, Stocks G, Crabtree JD Jr: Popliteal pseudoaneurysm following total knee arthroplasty. J Arthroplasty 1998, 13:830-832.
• [3]Gupta R, Chitre A, Ryan W: False aneurysm of the anterior tibial artery following total knee arthroplasty. Acta Orthop Belg 2008, 74:128-131.
• [4]Julien TP, Gravereaux E, Martin S: Superior medial geniculate artery pseudoaneurysm after primary total knee arthroplasty. J Arthroplasty 2011, 27:323.e13-323.e16.
• [5]Ibrahim M, Booth RE, Clark TWI: Embolization of traumatic pseudoaneurysms after total knee arthroplasty. J Arthroplasty 2004, 24:123-128.
• [6]Law KY, Cheung KW, Chiu KH: Pseudoaneurysm of the geniculate artery following total knee arthroplasty: a report of two cases. J Orthop Surg 2007, 15:386-389.
• [7]Pritsch T, Parnes N, Menachem A: A bleeding pseudoaneurysm of the lateral genicular artery after total knee arthroplasty- a case report. Acta Orthop 2005, 76(1):138-140.
• [8]Moran M, Hodgkinson J, Tait W: False aneurysm of the superior lateral geniculate artery following total knee replacement. Knee 2002, 9:349-351.
• [9]Rukavina A, Kerkhoffs GMMJ, Schneider P: Recurrent hemarthrosis after total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 2010, 18:898-900.
• [10]Bhan S, Malhotra R, Kiran EK: Comparison of total knee arthroplasty in stiff and ankylosed knees. Clin Orthop Relat Res 2006, 451:87-95.
• [11]Fosco M, Filanti M, Amendola L: Total knee arthroplasty in stiff knee compared with flexible knees. Musculoskelet Surg 2011, 95:7-12.
• [12]Calligaro KD, Dougherty MJ, Ryan S: Acute arterial complications associated with total hip and knee arthroplasty. J Vasc Surg 2003, 38:1170-1175.
• [13]Standring S: Gray’s Anatomy thirty ninth ed. Churchill- Livingstone: Elsevier; 2005:1486.
• [14]Sambaziotis C, Plymale M, Lovy A, Sambaziotis C, Plymale M, Lovy A: Pseudoaneurysm of the distal thigh after manipulation of a total knee arthroplasty. J Arthroplasty 2012, 27(7):1414. e5-7