Popliteal Venotomy During Posterior Cruciate Ligament Reconstruction in the Setting of a Popliteal Artery Bypass Graft
Abstract Injury to the vascular structures in the popliteal fossa during arthroscopic cruciate ligament reconstruction can be limb threatening or even life threatening. We present the first report, to our knowledge, of an isolated injury to a popliteal vein during arthroscopic posterior cruciate lig...
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| Published in | Arthroscopy Vol. 28; no. 2; pp. 294 - 299 |
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| Main Authors | , , , , , , |
| Format | Journal Article |
| Language | English |
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New York, NY
Elsevier Inc
01.02.2012
Elsevier |
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| Abstract | Abstract Injury to the vascular structures in the popliteal fossa during arthroscopic cruciate ligament reconstruction can be limb threatening or even life threatening. We present the first report, to our knowledge, of an isolated injury to a popliteal vein during arthroscopic posterior cruciate ligament reconstruction. Unfortunately, the venotomy led to cardiopulmonary arrest and flash pulmonary edema in this patient. Preoperative planning is paramount to assess risk of injury to vascular structures, which may be increased in patients who have had prior procedures on the affected knee. Furthermore, vascular surgery consultation preoperatively after a magnetic resonance angiogram or venogram and avoiding the use of epinephrine in the arthroscopy fluid should be considered when performing these higher-risk procedures. |
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| AbstractList | Abstract Injury to the vascular structures in the popliteal fossa during arthroscopic cruciate ligament reconstruction can be limb threatening or even life threatening. We present the first report, to our knowledge, of an isolated injury to a popliteal vein during arthroscopic posterior cruciate ligament reconstruction. Unfortunately, the venotomy led to cardiopulmonary arrest and flash pulmonary edema in this patient. Preoperative planning is paramount to assess risk of injury to vascular structures, which may be increased in patients who have had prior procedures on the affected knee. Furthermore, vascular surgery consultation preoperatively after a magnetic resonance angiogram or venogram and avoiding the use of epinephrine in the arthroscopy fluid should be considered when performing these higher-risk procedures. Injury to the vascular structures in the popliteal fossa during arthroscopic cruciate ligament reconstruction can be limb threatening or even life threatening. We present the first report, to our knowledge, of an isolated injury to a popliteal vein during arthroscopic posterior cruciate ligament reconstruction. Unfortunately, the venotomy led to cardiopulmonary arrest and flash pulmonary edema in this patient. Preoperative planning is paramount to assess risk of injury to vascular structures, which may be increased in patients who have had prior procedures on the affected knee. Furthermore, vascular surgery consultation preoperatively after a magnetic resonance angiogram or venogram and avoiding the use of epinephrine in the arthroscopy fluid should be considered when performing these higher-risk procedures. |
| Author | Warren, Russell F., M.D Nemani, Venu M., M.D., Ph.D Reinhardt, Keith R., M.D Pascual-Garrido, Cecilia, M.D Drakos, Mark, M.D Frank, Rachel M., M.D Yanke, Adam B., M.D |
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| Keywords | Arthroscopy Orthopedic surgery Posterior cruciate ligament Treatment Bypass Popliteal artery Graft Endoscopy |
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| References_xml | – volume: 19 start-page: 120 year: 2011 end-page: 130 ident: bib8 article-title: Combined PCL-ACL lateral and medial side injuries: Treatment and results publication-title: Sports Med Arthrosc contributor: fullname: Edson – volume: 85 start-page: 913 year: 2003 end-page: 915 ident: bib13 article-title: Epinephrine-induced pulmonary edema during arthroscopic knee surgery publication-title: J Bone Joint Surg Am contributor: fullname: Bush-Joseph – volume: 19 start-page: 889 year: 2003 end-page: 893 ident: bib5 article-title: Acute popliteal artery occlusion after arthroscopic posterior cruciate ligament reconstruction publication-title: Arthroscopy contributor: fullname: Wang – volume: 24 start-page: 1367 year: 2008 end-page: 1372 ident: bib7 article-title: Anatomic relation between the posterior cruciate ligament and the joint capsule publication-title: Arthroscopy contributor: fullname: Abdalla – volume: 20 start-page: E4 year: 2004 end-page: E6 ident: bib6 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Implications for posterior cruciate ligament reconstruction publication-title: Arthroscopy doi: 10.1053/jars.2000.18243 contributor: fullname: Matava – volume: 4 start-page: 215 year: 1988 ident: 10.1016/j.arthro.2011.11.023_bib3 article-title: Complications in arthroscopic surgery performed by experienced arthroscopists publication-title: Arthroscopy doi: 10.1016/S0749-8063(88)80030-6 contributor: fullname: Small – volume: 19 start-page: 889 year: 2003 ident: 10.1016/j.arthro.2011.11.023_bib5 article-title: Acute popliteal artery occlusion after arthroscopic posterior cruciate ligament reconstruction publication-title: Arthroscopy doi: 10.1016/S0749-8063(03)00747-3 contributor: fullname: Wu – volume: 12 start-page: 196 year: 2004 ident: 10.1016/j.arthro.2011.11.023_bib9 article-title: Complications of posterior cruciate ligament reconstruction publication-title: Sports Med Arthrosc doi: 10.1097/01.jsa.0000131856.35569.00 contributor: fullname: Fanelli |
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| Snippet | Abstract Injury to the vascular structures in the popliteal fossa during arthroscopic cruciate ligament reconstruction can be limb threatening or even life... Injury to the vascular structures in the popliteal fossa during arthroscopic cruciate ligament reconstruction can be limb threatening or even life threatening.... |
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| SubjectTerms | Arthroscopy Arthroscopy - adverse effects Biological and medical sciences Endoscopy Female Heart Arrest - etiology Humans Intraoperative Complications Investigative techniques, diagnostic techniques (general aspects) Medical sciences Orthopedic surgery Orthopedics Popliteal Artery - surgery Popliteal Vein - injuries Posterior Cruciate Ligament - injuries Posterior Cruciate Ligament - surgery Pulmonary Edema - etiology Reconstructive Surgical Procedures - adverse effects Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Vascular Surgical Procedures - adverse effects Young Adult |
| Title | Popliteal Venotomy During Posterior Cruciate Ligament Reconstruction in the Setting of a Popliteal Artery Bypass Graft |
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