Total knee arthroplasty in a patient with chronic occlusion of the superficial femoral artery.
In a 67-year-old patient with severe valgus gonarthrosis and chronic occlusion of the superficial femoral artery on the same side, total knee replacement was performed without preceding angioplasty because the collateral circulation was intact. No tourniquet was used. To leave the peripatellar arterial ring intact on one side in this case of lateral patellar maltracking, a lateral approach was used. In this approach, a lateral release forms part of the approach itself. To achieve gentle eversion of the patella, the tibial tubercle was osteotomized. One year postoperatively, the patient was satisfied with the outcome and showed no clinical signs of any vascular deterioration. It is concluded that total knee replacement may be possible in the presence of chronic occlusion of the superficial femoral artery provided that the collateral circulation is intact.
Endo-Clinic, Hamburg, Germany. mariusvonknoch@yahoo.com
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von Knoch
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Funke
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von Knoch
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Drobny
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Munzinger
D000368:Aged; D000792:Angiography; D001157:Arterial Occlusive Diseases / Q000150:complications* / Q000000981:diagnostic imaging; D019645:Arthroplasty, Replacement, Knee / Q000379:methods*; D002908:Chronic Disease; D005260:Female; D005263:Femoral Artery; D005500:Follow-Up Studies; D006801:Humans; D020370:Osteoarthritis, Knee / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery*; D010147:Pain Measurement; D016059:Range of Motion, Articular; D012720:Severity of Illness Index; D016896:Treatment Outcome