Dataset Information

Traumatic anterior dislocation of a prosthetic knee, from trauma to delayed onset of vascular injury.

ABSTRACT: Anterior dislocation of a prosthetic knee is a rare event. Only few episodes have been described in the past and have never been linked with neurovascular injury. This could lead orthopaedic surgeons to focus on the implant instability factors and underrate other complications. The authors report a case of a patient who experienced popliteal artery dissection 80 hours after traumatic anterior knee dislocation of a previously well-functioning total knee arthroplasty. Given that there is a lack of clinical cases that have established guidelines for management of this problem, the authors have focused on the importance of performing computed tomography angiography in the management of an anterior traumatic knee dislocation of a prosthetic knee.

SUBMITTER: Addevico F

PROVIDER: S-EPMC6287958 | biostudies-literature | 2018 Dec

REPOSITORIES: biostudies-literature

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Traumatic anterior dislocation of a prosthetic knee, from trauma to delayed onset of vascular injury.

Addevico Francesco F Nucci Anna Maria AM Rosati Marco M Poggetti Andrea A Scaglione Michelangelo M

Arthroplasty today 20181024 4

Anterior dislocation of a prosthetic knee is a rare event. Only few episodes have been described in the past and have never been linked with neurovascular injury. This could lead orthopaedic surgeons to focus on the implant instability factors and underrate other complications. The authors report a case of a patient who experienced popliteal artery dissection 80 hours after traumatic anterior knee dislocation of a previously well-functioning total knee arthroplasty. Given that there is a lack of ...[more]

PMID: 30569005

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Project description:BackgroundVascular injury secondary to an acute knee dislocation is a known complication. However, there exist wide discrepancies in the reported rate of vascular injury in this setting.Questions/purposesUsing a large private insurance database, we determined the frequency of vascular injury in knee dislocations across year of diagnosis, age, sex, and US geographic region and the proportion of these injuries requiring surgical repair.MethodsThe PearlDiver database, which contains records from 11 million orthopaedic patients, was searched using ICD-9 diagnostic codes for all knee dislocation events from 2004 to 2009. Within this subset, we identified which knee dislocations had an associated vascular injury ICD-9 code. Patients were stratified by year of diagnosis, age, sex, and US geographic region, and Current Procedural Terminology codes were used to identify the subset of patients with vascular injury requiring surgical repair. Differences in frequency across demographic groups and over time were analyzed with Poisson regression analysis.ResultsAmong the 8050 limbs with knee dislocation identified over the study period, 267 had a concomitant vascular injury for an overall frequency of 3.3%. Males were found to have an increased risk of vascular injury compared to females (odds ratio = 2.59, p < 0.001). Additionally, patients aged 20 to 39 years had a higher risk of vascular injury when compared to those aged 0 to 19 years (odds ratio = 1.93, p = 0.001), 40 to 59 years (odds ratio = 1.57, p = 0.014), and 60 years or older (odds ratio = 2.81, p = 0.036). There were no differences in vascular injury frequency across US geographic regions or diagnosis year. Thirty-four of the 267 cases of vascular injury (13%) underwent surgical treatment.ConclusionsThis is the largest study, to our knowledge, that analyzes the proportion of knee dislocations that result in vascular injury. Our data suggest that there is a lower frequency of vascular injury associated with knee dislocation and a lower proportion of vascular injuries undergoing surgical treatment than previously reported. These findings may support a more selective angiography protocol to screen for vascular injury, rather than performing this invasive diagnostic test on all knee dislocations, as has been done historically. Future large-scale and prospective studies should analyze factors that may predispose to vascular injuries after knee dislocation and determine which patients should be screened for vascular injury after knee dislocation.Level of evidenceLevel IV, prognostic study. See Instructions for Authors for a complete description of levels of evidence.

Dataset Information

Traumatic anterior dislocation of a prosthetic knee, from trauma to delayed onset of vascular injury.

Publications

Traumatic anterior dislocation of a prosthetic knee, from trauma to delayed onset of vascular injury.

Similar Datasets

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