RESUMEN
BACKGROUND: Although vascular disease is commonly accepted as a risk factor for wound complications and prosthetic joint infections, little is known about the preoperative prevalence of lower-extremity peripheral vascular disease in patients undergoing total knee arthroplasty (TKA). In this study, we investigated the prevalence of asymptomatic vascular disease and its risk factors. MATERIALS AND METHODS: A total of 1,000 knees of 692 patients who underwent primary TKA due to osteoarthritis were preoperatively evaluated by experienced musculoskeletal radiologists using Doppler ultrasonography of the lower extremity vessels. The mean age of the patients was 74.1 years (range 65-81). Risk factors for development of peripheral vascular disease were investigated. RESULTS: Abnormal findings were identified in 38 knees of 32 patients (4.6 %); atherosclerotic changes in 31 knees of 25 patients (3.6 %), deep vein thrombosis (DVT) in two knees, and anomalous vessels in five knees. Three out of 31 knees with atherosclerotic changes showed severe luminal stenosis. Two knees were moderate and 26 knees showed mild changes according to our institutional criteria. Multivariate logistic regression analysis showed that age and diabetes mellitus were positively associated with vascular pathology. CONCLUSION: The prevalence of incidentally detected peripheral vascular disease was significant. Three of 31 knees had severe arterial stenosis and two knees had DVT. All patients with vascular pathologies had one or more risk factors related to vascular disease. Out of those patients, age was the most important risk factor. Understanding the prevalence of vascular pathology and related risk factors in TKA candidates may be important for successful TKA. LEVEL OF EVIDENCE: Level III.
Asunto(s)
Artroplastia de Reemplazo de Rodilla , Extremidad Inferior/irrigación sanguínea , Osteoartritis de la Cadera/complicaciones , Enfermedades Vasculares Periféricas/epidemiología , Medición de Riesgo/métodos , Anciano , Anciano de 80 o más Años , China/epidemiología , Femenino , Humanos , Extremidad Inferior/diagnóstico por imagen , Masculino , Osteoartritis de la Cadera/cirugía , Enfermedades Vasculares Periféricas/complicaciones , Enfermedades Vasculares Periféricas/diagnóstico , Periodo Preoperatorio , Prevalencia , Estudios Retrospectivos , Factores de Riesgo , Ultrasonografía DopplerRESUMEN
Unstable inferior leaves of the anterior horn in horizontal tears of the lateral meniscus are challenging lesions for most orthopedic surgeons due to the poor viewing angle and the instability of these lesions. Resection of an exact volume is required for the successful treatment of horizontal tears in the lateral meniscus anterior horn. We report a method based on the joystick technique.