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Victor M Goldberg - One of the best experts on this subject based on the ideXlab platform.

  • injury to the Popliteal Artery and its anatomic location in total knee arthroplasty
    Journal of Arthroplasty, 1999
    Co-Authors: James T Ninomiya, John C Dean, Victor M Goldberg
    Abstract:

    Injury to the Popliteal Artery during total knee arthroplasty (TKA) is a devastating complication. Although infrequent, these injuries can result in the need for further surgery, including revascularization or possibly even amputation. Several mechanisms are capable of producing direct trauma to the Popliteal Artery, including the use of posterior ret ractors. We investigated the proximity of the Popliteal Artery to the tibial joint surface during TKA to identify crucial steps in the procedure at which the Artery was at highest risk for injury. TKA was performed on cadaveric specimens, and serial intraoperative arteriograms were taken throughout the procedure, demonstrating the potential for arterial injury by the instrumentation. Additionally, 50 transverse magnetic resonance imaging scans of unrelated knees were analyzed for the position of the Popliteal Artery relative to the midline of the tibial plateau as well as at a level 5 to 10 mm below this, at the site of a typical resection during TKA. All of the arteriograms showed the Artery to be a lateral structure at the joint line. Additionally a posterior retractor placed the Artery at risk when it was placed in a position lateral to the posterior cruciate ligament or when it was injudiciously inserted more than 1 cm into the soft tissues. Hyperextension of the knee, which might occur during preparation of the patella, produced dramatic tenting of the Artery over the posterior joint line. These results demonstrate that the Popliteal Artery is at significant risk during TKA, particularly if posterior retractors are placed in a position lateral to the midline of the joint. Both hyperflexion and especially hyperextension produced severe deformities and kinking of the Artery and would particularly jeopardize an Artery with atherosclerosis. Our findings suggest that the Popliteal Artery may be at least risk during TKA if posterior retractors are placed medial to the midline of the tibial plateau and if care is taken to avoid extremes of both flexion and extension.

Thomas W. Huff - One of the best experts on this subject based on the ideXlab platform.

  • Popliteal Artery injury associated with total knee arthroplasty: Trends, costs and risk factors
    Journal of Arthroplasty, 2014
    Co-Authors: Laura Matsen Ko, Matthew L. Dehart, Thomas W. Huff
    Abstract:

    Abstract Popliteal Artery injury is a relatively rare but potentially devastating complication of total knee arthroplasty (TKA). We analyzed the Nationwide Inpatient Sample from 1998 to 2009 to determine the actual incidence, risk factors and consequences of this complication. There were 1,120,508 hospitalizations coded for TKA; of these, 633 (0.057%) were identified as having a Popliteal Artery injury. The rate of injury remained relatively constant though the number of both TKAs and injuries have risen annually by 0.65% and 0.5%, respectively. Significant risk factors included revision surgery, peripheral vascular disease, weight loss, renal failure, coagulopathy, and metastatic cancer. Consequences were increased hospital charges, length of stay, and mortality rates. Because the rate of Popliteal Artery injury is not diminishing with time and morbidity and mortality are high, patients should be assessed for known risk factors for Popliteal Artery injury.

G Bentley - One of the best experts on this subject based on the ideXlab platform.

  • danger to the Popliteal Artery in high tibial osteotomy
    Journal of Bone and Joint Surgery-british Volume, 1995
    Co-Authors: Shoaib Hasan Zaidi, A G Cobb, G Bentley
    Abstract:

    We report a case in which the Popliteal Artery was divided during upper tibial osteotomy performed with the knee in 90 degrees of flexion. This position is believed to allow it to fall safely back from the tibia, but we could find no published confirmation. We used duplex ultrasonography in ten healthy volunteers to measure the distance from the Popliteal Artery to the posterior surface of the tibia at various degrees of flexion of the knee. Our results showed that in 12 of 20 knees the Popliteal Artery was closer to the tibia in 90 degrees of knee flexion than in full extension. Surgeons performing upper tibial osteotomy should be aware that flexing the knee does not protect the Popliteal Artery from injury.

Roberto Chiesa - One of the best experts on this subject based on the ideXlab platform.

Joseph J Ricotta - One of the best experts on this subject based on the ideXlab platform.

  • endovascular repair of a ruptured giant Popliteal Artery aneurysm
    Perspectives in Vascular Surgery and Endovascular Therapy, 2009
    Co-Authors: Yevgeniy Rits, Young Erben, Joseph J Ricotta
    Abstract:

    This report presents the first reported case of an endovascular repair of a ruptured giant Popliteal Artery aneurysm. The patient, an 86-year-old man, presented emergently with a free rupture of a 7-cm left Popliteal Artery aneurysm and a large hematoma in his left thigh of approximately 20 cm in diameter. The patient was considered to be at high risk for open surgery and therefore underwent endovascular repair of his ruptured Popliteal Artery aneurysm using two 8 mm × 15 mm Viabahn endografts. At one month follow-up, the large hematoma in the left thigh had completely resolved, the patient was ambulating without pain or difficulty and had palpable pedal pulses on physical examination. One year following the procedure, the endografts remained patent without endoleak.