Late-Diagnosed Arterial Thrombosis Mimicking Complex Regional Pain Syndrome After TKR in a Patient With CREST Syndrome
Abstract
Arterial thrombosis after total knee replacement (TKR) is a rare complication; however, it can lead to disastrous consequences. We describe a case of an arterial occlusion after TKR in an 85-year-old female patient. Initially, the clinical presentation made us consider Raynaud (she had a history of CREST) and complex regional pain syndrome, which delayed the diagnosis for 2 weeks. Diagnosis and treatment were accomplished with angiography and the patient achieved a full recovery. The low frequency of this injury may make diagnosis a challenge for the surgeon. In this case, partial occlusion of the arteries avoided more serious complications.Downloads
References
Abularrage CJ, Weiswasser JM, Dezee KJ, Slidell MB, Henderson WG, Sidawy AN. Predictors of lower extremity
arterial injury after total knee or total hip arthroplasty. J Vasc Surg 2008;47(4):803-7. https://doi.org/10.1016/j.jvs.2007.11.067
Calligaro KD, Dougherty MJ, Ryan S, Booth RE. Acute arterial complications associated with total hip and knee
arthroplasty. J Vasc Surg 2003;38(6):1170-7. https://doi.org/10.1016/s0741-5214(03)00918-2
Sharma H, Singh GK, Cavanagh SP, Kay D. Pseudoaneurysm of the inferior medial geniculate artery following
primary total knee arthroplasty: delayed presentation with recurrent haemorrhagic episodes. Knee Surg Sports
Traumatol Arthrosc 2006;14(2):153-5. https://doi.org/10.1007/s00167-005-0639-4
Dennis DA, Neumann RD, Toma P, Rosenberg G, Mallory TH. Arteriovenous fistula with false aneurysm of the
inferior medial geniculate artery. Clin Orthop Relat Res 1987(222):255-60. PMID: 3621729
Youssef P, Englert H, Bertouch J. Large vessel occlusive disease associated with CREST syndrome and
scleroderma. Ann Rheum Dis 1993;52(6):464-6. https://doi.org/10.1136/ard.52.6.464
Dorevitch MI, Clemens LE, Webb JB. Lower limb amputation secondary to large vessel involvement in
sclerodermia. Br J Rheumatol 1988;27(5):403-6. https://doi.org/10.1093/rheumatology/27.5.403
Man A, Zhu Y, Zhang Y, Dubreuil M, Rho YH, Pelo-quin C, et al. The risk of cardiovascular disease in systemic
sclerosis: a population-based cohort study. Ann Rheum Dis 2013;72(7):1188-93. https://doi.org/10.1136/annrheumdis-2012-202007
Pal A, Clarke JMF, Cameron AEP. Case series and literature review: Popliteal artery injury following total knee
replacement. Int J Surg 2010;8(6):430-5. https://doi.org/10.1016/j.ijsu.2010.04.008
Bagla S, Rholl KS, van Breda A, Sterling KM, van Breda A. Geniculate artery embolization in the management of
spontaneous recurrent hemarthrosis of the knee: case series. J Vasc Interv Radiol 2013;24(3):439-42.
https://doi.org/10.1016/j.jvir.2012.11.011
Sadat U, Naik J, Verma P, See TC, Cousins C, Chitnavis JP, et al. Endovascular management of pseudoaneurysms following lower limb orthopedic surgery. Am J Orthop (Belle Mead NJ) 2008;37(5):E99-E102. PMID: 18587511
Manuscript acceptance by the Journal implies the simultaneous non-submission to any other journal or publishing house. The RAAOT is under the Licencia Creative Commnos Atribución-NoComercial-Compartir Obras Derivadas Igual 4.0 Internacional (CC-BY-NC.SA 4.0) (http://creativecommons.org/licences/by-nc-sa/4.0/deed.es). Articles can be shared, copied, distributed, modified, altered, transformed into a derivative work, executed and publicly communicated, provided a) the authors and the original publication (Journal, Publisher and URL) are mentioned, b) they are not used for commercial purposes, c) the same terms of the license are maintained.
In the event that the manuscript is approved for its next publication, the authors retain the copyright and will assign to the journal the rights of publication, edition, reproduction, distribution, exhibition and communication at a national and international level in the different databases. data, repositories and portals.
It is hereby stated that the mentioned manuscript has not been published and that it is not being printed in any other national or foreign journal.
The authors hereby accept the necessary modifications, suggested by the reviewers, in order to adapt the manuscript to the style and publication rules of this Journal.
