Pseudoaneurysm after Knee Arthroscopic Synovectomy in a Septic Arthritis Patient

Sung Jun Lee; Oog Jin Sohn; Seung Min Ryu; Hodong Na; Woo-Sung Yun

doi:10.4055/jkoa.2018.53.1.71

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Lee, Sohn, Ryu, Na, and Yun: Pseudoaneurysm after Knee Arthroscopic Synovectomy in a Septic Arthritis Patient

Case Report

Journal of the Korean Orthopaedic Association 2018; 53(1): 71-75.

Published online: 28 February 2018

DOI: https://doi.org/10.4055/jkoa.2018.53.1.71

Pseudoaneurysm after Knee Arthroscopic Synovectomy in a Septic Arthritis Patient

Sung Jun Lee, M.D., Oog Jin Sohn, M.D., Seung Min Ryu, M.D., Ph.D., Hodong Na, M.D., Woo-Sung Yun, M.D.^*

Department of Orthopedic Surgery, Yeungnam University Medical Center, Daegu, Korea.

^*Division of Transplantation and Vascular Surgery, Department of Surgery, Yeungnam University Medical Center, Daegu, Korea.

Correspondence to: Seung Min Ryu, M.D., Ph.D. Department of Orthopedic Surgery, Yeungnam University Medical Center, 170 Hyeonchung-ro, Nam-gu, Daegu 42415, Korea. TEL: +82-53-620-3640, FAX: +82-53-620-4020, karaz101@ynu.ac.kr

Received 21 January 2016 Revised 27 March 2016 Accepted 9 May 2017

The Korean Orthopaedic Association

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Arthroscopic synovectomy is a widely-used method to treat septic knee arthritis. To date, many authors have reported minimal complications related to arthroscopic treatment, especially vascular injuries. A three-dimensional computed tomography angiography revealed a pseudoaneurysm that arise from the popliteal artery near the arthroscopic site in septic arthritis patients with atherosclerosis and neurofibromatosis. A careful arthroscopic procedure via the posteromedial or posterolateral portal is recommended for the prevention of this complication. We, therefore, recommend close observation after arthroscopic procedure, despite the occurrence of complications; nonetheless, early diagnosis and treatment are important. We report a case of pseudoaneurysm of the popliteal artery with a complicating arthroscopic synovectomy in septic arthritis with literature review.

Keywords: knee, arthroscopy, debridement, pseudoaneurysm

Figures and Tables

Figure 1

Three-dimensional computed tomography angiography. White arrowhead shows pseudoaneurysm originating from the popliteal artery of the left lower leg. H, head; F, foot.

Figure 2

(A) Preoperative popliteal arteriography shows contrast leakage on the popliteal artery. (B) Postoperative popliteal arteriography shows normal blood flow of the popliteal artery.

Notes

^{CONFLICTS OF INTEREST} The authors have nothing to disclose.

References

1. Dubost JJ, Soubrier M, Sauvezie B. Pyogenic arthritis in adults. Joint Bone Spine. 2000; 67:11–21.

2. Wirtz DC, Marth M, Miltner O, Schneider U, Zilkens KW. Septic arthritis of the knee in adults: treatment by arthroscopy or arthrotomy. Int Orthop. 2001; 25:239–241.

3. DeLee JC. Complications of arthroscopy and arthroscopic surgery: results of a national survey. Committee on Complications of Arthroscopy Association of North America. Arthroscopy. 1985; 1:214–220.

4. Small NC. Complications in arthroscopy: the knee and other joints. Committee on Complications of the Arthroscopy Association of North America. Arthroscopy. 1986; 2:253–258.

5. Massin MM, Hövels-Gürich H, Seghaye MC. Atherosclerosis lifestyle risk factors in children with congenital heart disease. Eur J Cardiovasc Prev Rehabil. 2007; 14:349–351.

6. van Popele NM, Grobbee DE, Bots ML, et al. Association between arterial stiffness and atherosclerosis: the Rotterdam Study. Stroke. 2001; 32:454–460.

7. Salyer WR, Salyer DC. The vascular lesions of neurofibromatosis. Angiology. 1974; 25:510–519.

8. Dennis DA, Neumann RD, Toma P, Rosenberg G, Mallory TH. Arteriovenous fistula with false aneurysm of the inferior medial geniculate artery. A complication of total knee arthroplasty. Clin Orthop Relat Res. 1987; (222):255–260.

9. Sloan K, Mofidi R, Nagy J, Flett MM, Chakraverty S. Endovascular treatment for traumatic popliteal artery pseudoaneurysms after knee arthroplasty. Vasc Endovascular Surg. 2009; 43:286–290.

10. Colborn GL, Lumsden AB, Taylor BS, Skandalakis JE. The surgical anatomy of the popliteal artery. Am Surg. 1994; 60:238–246.

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