• Mahmoud M Abdel Karim, Ashraf Anbar, and Jonathan Keenan.
• Department of Orthopaedic Surgery, Plymouth NHS Trust, Derriford Hospital, Plymouth PL6 8DH, UK. mabdelkarim@hotmail.com
• Arch Orthop Trauma Surg. 2012 Jun 1;132(6):861-5.

BackgroundInjury to the popliteal artery during total knee arthroplasty is a devastating complication. This topic was studied previously prior to primary total knee arthroplasty. This study aims to demonstrate the position of the popliteal artery in patients prior to revision total knee replacement.MethodsThe ultrasound scan results of the position of the popliteal artery in 23 patients were reviewed. The implant/artery distance at different levels was measured with the knee in extension and 70°-90° of flexion.ResultsThere was no significant difference in the artery position at the level of the tibial metal base plate (the most critical site) on moving the knee from extension to flexion (P = 0.26). However, the implant/artery distance was found to increase on moving from extension to flexion in relation to the femoral component at the joint line (69%), as well as 15 mm below the level of the tibial base plate representing 69.3%. There was a significant difference at 15 mm above the joint line, where the distance was found to be increased in 84.6% of cases (P = 0.019).ConclusionThis study has shown that in a revision knee situation, there is no reliable fall back of the popliteal artery in knee flexion; in fact, implant/artery distance may be decreased and caution must be exercised throughout the procedure. It may be worth considering either ultrasound or arteriography in selected cases.

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