TAILIEUCHUNG - Biến chứng động mạch

Biến chứng động mạch sau khi tổng arthroplasty đầu gối (TKA) là rất hiếm, tuy nhiên, di chứng có thể là thảm hoạ. Nhiễm trùng và sự cần thiết phải cắt cụt hoặc phẫu thuật tái tạo mạch máu không phải là hiếm. Đánh giá kỹ lưỡng trước phẫu thuật có thể xác định bệnh nhân có nguy cơ, nhiều, nếu không phải tất cả, | Arterial Complications and Total Knee Arthroplasty Donna E. Smith MD Robert W. McGraw MD David C. Taylor MD and Eĩassam A. .Masri MD Abstract Arterial complications after total knee arthroplasty TKA are rare however the sequelae can be disastrous. Infection and the need for amputation or vascular reconstructive surgery are not uncommon. A thorough preoperative assessment can identify at-risk patients many if not all of whom have preexisting peripheral arterial disease. In the presence of peripheral arterial disease the use of a tourniquet during TKA has been implicated in subsequent arterial complications. Following the guidelines that have been established regarding preoperative assessment the role of the vascular surgeon and the use of a tourniquet before and during TKA can assist the orthopaedic surgeon in assessing candidates for TKA and reducing the risk of arterial complications. J Am Acad Orthop Surg 2001 9 253-257 Arterial complications after total knee arthroplasty TKA are quite rare and the scant literature regarding this topic consists mainly of case Calligaro et al14 reviewed 4 097 TKAs performed at their hospital and found that 7 patients had acute ischemia after the procedure. On analysis of 9 022 arthroplasties Rand15 found 3 cases of postoperative arterial complications incidence of . A tourniquet was used in almost all reported cases. In all of these reported cases the patients had acute thrombosis rather than vessel laceration. Because of these and other associated complications there have been concerns about the use of a tourniquet during Arterial ischemia following TKA can lead to serious complications such as problems with wound healing infection and limb loss. Because of the relatively poor vascularity of the skin surrounding the knee arterial injury can compromise wound healing in an already disadvantaged limb and can lead to deep infection. In already ischemic limbs further arterial injury or deep infection .

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