Vascular injuries after total joint arthroplasty.
Vascular injuries, although highly feared, can occur after total joint arthroplasty, often resulting in legal suits. This study evaluates the circumstances related to vascular injuries after joint arthroplasty. Using prospectively collected data on 13,517 patients undergoing total joint arthroplasty at our institution, 16 (0.1%) vascular injuries were identified. Eleven injuries occurred after total knee arthroplasty (TKA) and 5 after total hip arthroplasty (THA). Indirect injury was the most common mechanism in TKA. In contrast, direct injury was most prevalent in THA. One patient died of complications related to vascular injury. Of 16 patients, 8 (50%) had launched a legal suit against the operating surgeon. There appears to be no further specific measure that can be taken to absolutely avoid this complication. Patient awareness regarding this real problem may play a role in defraying the high likelihood of legal suits associated with this complication.
Parvizi
Javad
J
Rothman Institute of Orthopedics at Thomas Jefferson University, Philadelphia, Pennsylvania 19107, USA.
Pulido
Luis
L
Slenker
Nicholas
N
Macgibeny
Margaret
M
Purtill
James J
JJ
Rothman
Richard H
RH
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects* / Q000331:legislation & jurisprudence; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects* / Q000331:legislation & jurisprudence; D005260:Female; D005263:Femoral Artery / Q000293:injuries* / Q000601:surgery; D006801:Humans; D007083:Iliac Artery / Q000293:injuries* / Q000601:surgery; D008297:Male; D008318:Malpractice / Q000331:legislation & jurisprudence; D008875:Middle Aged; D011150:Popliteal Artery / Q000293:injuries* / Q000601:surgery; D011446:Prospective Studies; D012189:Retrospective Studies; D013927:Thrombosis / Q000209:etiology* / Q000601:surgery; D016896:Treatment Outcome; D014652:Vascular Diseases / Q000209:etiology* / Q000601:surgery; D014656:Vascular Surgical Procedures; D055815:Young Adult