Acute Surgical Management of Vascular Injuries in Hip and Knee Arthroplasties.

J Am Acad Orthop Surg · Nov 01 2020 · Review

Melnic CM, Heng M, Lozano-Calderon SA

From the Department of Orthopaedic Surgery (Dr. Melnic), Massachusetts General Hospital/Newton Wellesley Hospital,…

Adult Reconstruction

SUMMARY — THE REDUCTIONThis review covers hip and knee vascular anatomy and techniques for gaining proximal control and managing rare but devastating vascular injuries in arthroplasty, especially when vascular surgeons are unavailable in ambulatory settings.
Abstract, as published

With an increasing number of total hip and knee arthroplasties being done at surgical centers and vascular surgeons often not immediately available in this setting, it is critical for orthopaedic surgeons to be comfortable with the acute surgical management of vascular injuries. Although they are fortunately uncommon in primary total hip and knee arthroplasties, damage to a major artery or vein can have potentially devastating consequences. Surgeons operating both in a hospital and an ambulatory surgical setting should be familiar with techniques to gain proximal control of massive bleeding because the principles can be helpful in primary and revision arthroplasties. In this study, we review the vascular anatomy around the hip and knee and the surgical management of these potentially catastrophic complications.

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