title: The national incidence of iatrogenic popliteal artery injury during total knee replacement.
abstract: BACKGROUND
  The aim of this study was to characterize national characteristics of patients who have a total knee replacement complicated by popliteal artery injury by incidence and patient demographics.
  
  
  METHODS
  All patients with ICD-9 confirmed total knee replacement who had an iatrogenic popliteal artery injury were included from the national in-patient sample from 1998 to 2011. Age, gender and race, procedure type, time to popliteal artery injury, limb outcome, length of stay and hospital inpatient charges were reported.
  
  
  RESULTS
  A total of 1,297,369 patients underwent a total knee replacement of which 43 were complicated by popliteal artery injury (0.003%); 93% had osteoarthritis as their primary diagnosis. The mean age was 61.7 ± 12.3 years. In all, 96% of patients had their popliteal injuries detected intra-operatively or on the day of total knee replacement surgery. The majority of these patients either received stent placement (44%) or peripheral bypass (30%) as their treatment modality for popliteal artery injury. There were no amputations or deaths in this cohort. The median hospital charges for this group were $27,570 (2014 USD).
  
  
  CONCLUSIONS
  The national incidence of iatrogenic popliteal artery injury in patients undergoing TKR is 0.003%. There were no amputations in our study population and 96% of patients had their injury detected intra-operative or immediately post-operatively.
authors.affiliation: Department of Surgery, Medical College of Wisconsin, Milwaukee, WI, USA Center for Translational Injury Research (CeTIR), Department of Surgery, University of Texas-Houston, Houston, TX, USA andua@mcw.edu.
authors.forename: Anahita
authors.initials: A
authors.lastname: Dua
authors.affiliation: National Autonomous University of Nicaragua, Managua, Nicaragua.
authors.forename: Reyna
authors.initials: R
authors.lastname: Zepeda
authors.affiliation: University of Carabobo School of Medicine, Valencia, Venezuela.
authors.forename: Francisco C
authors.initials: FC
authors.lastname: Hernanez
authors.affiliation: Ambrose Alli University College of Medicine, Ekpoma, Nigeria.
authors.forename: Anthony A
authors.initials: AA
authors.lastname: Igbadumhe
authors.affiliation: Department of Vascular Surgery, Southern Illinois University, Springfield, IL, USA.
authors.forename: Sapan S
authors.initials: SS
authors.lastname: Desai
mesh_terms: D000368:Aged; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects*; D003430:Cross-Sectional Studies; D057510:Endovascular Procedures / Q000191:economics / Q000295:instrumentation; D005260:Female; D017722:Hospital Charges; D006801:Humans; D007049:Iatrogenic Disease / Q000191:economics / Q000453:epidemiology*; D015994:Incidence; D023821:Limb Salvage; D008297:Male; D008875:Middle Aged; D011150:Popliteal Artery / Q000293:injuries*; D012189:Retrospective Studies; D015607:Stents / Q000191:economics; D013997:Time Factors; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology; D058017:Vascular Grafting / Q000191:economics; D057772:Vascular System Injuries / Q000175:diagnosis / Q000191:economics / Q000453:epidemiology* / Q000628:therapy
keywords: Total knee replacement; iatrogenic popliteal artery injury; limb salvage in iatrogenic injury; vascular injury and total knee replacement