We have investigated iatrogenic popliteal artery
injuries (PAI) during non arthroplasty knee surgery regarding mechanism
of injury, treatment and outcomes, and to identify successful strategies
when injury occurs. In all, 21 iatrogenic popliteal artery injuries in 21 patients
during knee surgery other than knee arthroplasty were identified
from the Swedish Vascular Registry (Swedvasc) between 1987 and 2011.
Prospective registry data were supplemented with case-records, including
long-term follow-up. In total, 13 patients suffered PAI during elective surgery
and eight during urgent surgery such as fracture fixation or tumour
resection. Nine injuries were detected intra-operatively, five within
12 to 48 hours and seven >
48 hours post-operatively (two days to
23 years). There were 19 open vascular and two endovascular surgical repairs.
Two patients died within six months of surgery. One patient required
amputation. Only six patients had a complete recovery of whom had
the vascular injury detected at time of injury and repaired by a
vascular surgeon. Patients sustaining vascular injury during elective
procedures are more likely to litigate (p = 0.029). We conclude that outcomes are poorer when there is a delay of
diagnosis and treatment, and that orthopaedic surgeons should develop
strategies to detect PAI early and ensure rapid access to vascular
surgical support. Cite this article:
