Dataset Information

Knee dislocation with popliteal artery disruption: A nationwide analysis from 2005 to 2013.

ABSTRACT:

Objective

Few have compared short-term outcomes following knee dislocations with or without concomitant popliteal artery disruption (PAD).

Methods

The Nationwide Inpatient Sample was used to identify 2175 patients admitted for knee dislocation from 2005 to 2013 (concomitant PAD: n = 210/9.7%; without: n = 1965/90.3%).

Results

Patients with PAD were younger, more often male, Black and Hispanic, and with Medicaid (all p ≤ 0.013). PADs were associated with 11.0-times higher odds of increased LOS (95%CI, 6.6-18.4) and 2.8-times higher odds of experiencing any complication (95%CI, 2.03-3.92). Female sex was a protective factor against increased LOS, (OR = 0.65; 95%CI, 0.48-0.88).

Conclusion

High suspicion index should be maintained for concomitant vascular injuries following knee dislocations.

SUBMITTER: Naziri Q

PROVIDER: S-EPMC6104139 | biostudies-literature | 2018 Sep

REPOSITORIES: biostudies-literature

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Publications

Knee dislocation with popliteal artery disruption: A nationwide analysis from 2005 to 2013.

Naziri Qais Q Beyer George A GA Shah Neil V NV Solow Maximillian M Hayden Andrew J AJ Nadarajah Vidushan V Ho Derek D Newman Jared M JM Boylan Matthew R MR Basu Niladri N NN Zikria Bashir A BA Urban William P WP

Journal of orthopaedics 20180816 3

<h4>Objective</h4>Few have compared short-term outcomes following knee dislocations with or without concomitant popliteal artery disruption (PAD).<h4>Methods</h4>The Nationwide Inpatient Sample was used to identify 2175 patients admitted for knee dislocation from 2005 to 2013 (concomitant PAD: n = 210/9.7%; without: n = 1965/90.3%).<h4>Results</h4>Patients with PAD were younger, more often male, Black and Hispanic, and with Medicaid (all p ≤ 0.013). PADs were associated with 11.0-times higher od ...[more]

PMID: 30140130

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Project description:ObjectivePopliteal artery injury is a rare but serious complication of arthroscopic knee surgery. The absence of comprehensive data and standardized guidelines underscores the urgent need for further investigation. This study examines the incidence, risk factors, management strategies, and long-term outcomes of popliteal artery injury in the context of arthroscopic knee procedures.MethodsWe conducted a retrospective cohort study utilizing data from 21 medical institutions in Hunan Province, China, from January 2018 to December 2022. We identified patients who underwent arthroscopic knee surgery and complained of postsurgical popliteal artery injury. Patients were followed up for 43.1 ± 13.23 months (ranging from 22 to 58 months). The primary outcome was joint function, which was evaluated by a postoperative range of motion (ROM), International Knee Documentation Committee (IKDC) scores, Lysholm knee scores, and Visual Vascular Quality of Life Questionnaire (VascuQoL) scores. These data from different postoperative periods were compared via paired t-test to assess postoperative recovery. The secondary outcome was vascular patency of the affected limb, which was evaluated through vascular color Doppler ultrasound.ResultsAmong the 17,000 knee arthroscopic procedures analyzed, 10 patients were identified with popliteal artery injury (0.059%). The surgeries performed included arthroscopic cystectomy for popliteal cysts, cruciate ligament reconstruction, and posterior horn of the lateral meniscus repair. Treatments for popliteal artery injury included percutaneous intravascular stent implantation (one patient), direct suture repair (four patients), allograft vascular transplantation (one patient), and reconstruction with an autogenous greater saphenous vein (four patients). After a mean follow-up time of 43.1 ± 13.23 months (ranging from 22 to 58 months), no complications were reported. Compared with patients at 1 month after surgery, patients at 2 years after surgery presented improved knee function and ROM. The average Lysholm score increased significantly from 13.8 ± 4.21 to 68.2 ± 15.50, the IKDC score increased from 11.6 ± 2.46 to 48.1 ± 11.75, and the VascuQoL score improved from 54.8 ± 9.54 to 92.5 ± 15.90. Knee extension improved from 13.3° ± 2.36° to 3.5° ± 4.12°, and knee flexion increased from 49.5° ± 12.57° to 107° ± 21.63°. All patients successfully resumed daily activities postoperatively.ConclusionPopliteal artery injury is a catastrophic complication that warrants significant attention during knee arthroscopy. This injury can occur in various types of arthroscopic knee procedures. Prompt diagnosis and effective intervention are crucial for minimizing the potential detriment associated with popliteal artery injury.

Project description:ObjectiveInfrarenal abdominal aortic aneurysm (AAA) and popliteal artery aneurysm (PAA) are localized arterial dilatations with distinct clinical outcomes. This study aimed to comprehensively compare these two types of aneurysms' biomechanical, histological, and immunohistochemical characteristics.MethodsThis study included 180 patients with AAA and 18 with PAA. Medical history and imaging data were collected. Biomechanical testing assessed arterial wall mechanical strength and elasticity, and histological and immunohistochemical analyses examined tissue composition and inflammatory markers.ResultsPAA wall fragments demonstrate higher failure strain energy (13.36 N/m2 vs 9.95 N/m2; P = .023), a measure of mechanical strength. Regarding immunohistochemical markers, AAA exhibited more B lymphocyte cells in the adventitia (CD20 1475.50 vs 320; P = .003) compared with PAA. Additionally, AAA demonstrated more adipogenic differentiation in the adventitia (PPARgamma 4854.50 vs 778; P = .009), whereas PAA showed more adipogenic differentiation in the intima (KLF5 283.50 vs 77.50; P = .039).ConclusionsPAA wall fragments demonstrate greater mechanical strength compared with AAA wall fragments. In contrast, AAA walls contain a greater number of B lymphocytes within the adventitia compared with PAA walls. Adipogenic differentiation is more pronounced in the adventitia of AAA than in PAA, whereas in PAA, it is more prominent in the intima compared with AAA.Clinical relevanceThe clinical significance of this study lies in its potential to enhance our understanding of the distinct pathophysiological mechanisms underlying abdominal aortic aneurysms, which is often associated with rupture, and popliteal artery aneurysms, which are more prone to thrombosis and distal embolization. By comprehensively comparing the biomechanical, histological, and immunohistochemical aspects of these two aneurysm types, the study aims to illuminate the factors contributing to their differing clinical presentations and outcomes.

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Dataset Information

Knee dislocation with popliteal artery disruption: A nationwide analysis from 2005 to 2013.

Objective

Methods

Results

Conclusion

Publications

Knee dislocation with popliteal artery disruption: A nationwide analysis from 2005 to 2013.

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