Popliteal Artery Injury After Arthroscopic Knee Surgery: A Retrospective Multicenter Cohort Study

ABSTRACT Objective Popliteal 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...

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Main Authors: Zhenmu Xu, Kai Jiang, Yueming Chen, Hao He, Weihong Zhu
Format: Article
Language:English
Published: Wiley 2025-03-01
Series:Orthopaedic Surgery
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Online Access:https://doi.org/10.1111/os.14334
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author Zhenmu Xu
Kai Jiang
Yueming Chen
Hao He
Weihong Zhu
author_facet Zhenmu Xu
Kai Jiang
Yueming Chen
Hao He
Weihong Zhu
author_sort Zhenmu Xu
collection DOAJ
description ABSTRACT Objective Popliteal 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. Methods We 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. Results Among 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. Conclusion Popliteal 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.
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spelling doaj-art-0b11ef72aea04c128f39147c561fd6332025-08-20T02:00:56ZengWileyOrthopaedic Surgery1757-78531757-78612025-03-0117382283010.1111/os.14334Popliteal Artery Injury After Arthroscopic Knee Surgery: A Retrospective Multicenter Cohort StudyZhenmu Xu0Kai Jiang1Yueming Chen2Hao He3Weihong Zhu4Department of Orthopaedics The Second Xiangya Hospital of Central South University Changsha Hunan ChinaDepartment of Orthopaedics The First Hospital of Hunan University of Chinese Medicine Changsha Hunan ChinaDepartment of Orthopaedics Central Hospital of Shaoyang Shaoyang Hunan ChinaDepartment of Vascular Surgery, The Second Xiangya Hospital Central South University Changsha ChinaDepartment of Orthopaedics The Second Xiangya Hospital of Central South University Changsha Hunan ChinaABSTRACT Objective Popliteal 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. Methods We 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. Results Among 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. Conclusion Popliteal 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.https://doi.org/10.1111/os.14334arthroscopic knee surgeryendovascular treatmentpopliteal artery injury
spellingShingle Zhenmu Xu
Kai Jiang
Yueming Chen
Hao He
Weihong Zhu
Popliteal Artery Injury After Arthroscopic Knee Surgery: A Retrospective Multicenter Cohort Study
Orthopaedic Surgery
arthroscopic knee surgery
endovascular treatment
popliteal artery injury
title Popliteal Artery Injury After Arthroscopic Knee Surgery: A Retrospective Multicenter Cohort Study
title_full Popliteal Artery Injury After Arthroscopic Knee Surgery: A Retrospective Multicenter Cohort Study
title_fullStr Popliteal Artery Injury After Arthroscopic Knee Surgery: A Retrospective Multicenter Cohort Study
title_full_unstemmed Popliteal Artery Injury After Arthroscopic Knee Surgery: A Retrospective Multicenter Cohort Study
title_short Popliteal Artery Injury After Arthroscopic Knee Surgery: A Retrospective Multicenter Cohort Study
title_sort popliteal artery injury after arthroscopic knee surgery a retrospective multicenter cohort study
topic arthroscopic knee surgery
endovascular treatment
popliteal artery injury
url https://doi.org/10.1111/os.14334
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AT yuemingchen poplitealarteryinjuryafterarthroscopickneesurgeryaretrospectivemulticentercohortstudy
AT haohe poplitealarteryinjuryafterarthroscopickneesurgeryaretrospectivemulticentercohortstudy
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