November 09, 2024
1 min learn
Key takeaways:
- Surgeons want to stay calm however diligent with the prevalence of a vascular damage throughout whole knee arthroplasty.
- If surgical procedure is carried out in an ASC, there ought to be a plan in place in case of vascular damage.
DALLAS — Whereas uncommon, vascular accidents throughout whole knee arthroplasty do happen, with the commonest being damage to the popliteal artery, in response to a presenter on the American Affiliation of Hip and Knee Surgeons Annual Assembly.
In his presentation, Christopher Melnic, MD, mentioned there are two key pillars for profitable administration of vascular accidents to the popliteal artery within the OR.
Whereas uncommon, vascular accidents throughout whole knee arthroplasty do happen, with the commonest being damage to the popliteal artery. Picture: Adobe Inventory
“The primary is to stay calm, however diligent,” Melnic, director of the Grownup Reconstructive Surgical procedure Fellowship Program at Massachusetts Normal Hospital and assistant professor of orthopedic surgical procedure at Harvard Medical College, mentioned. “Additionally, have clear communication, not solely with anesthesia however the nursing employees that’s within the working room.”
Christopher Melnic
If a tourniquet will not be positioned, Melnic mentioned to use agency stress, seek the advice of a vascular surgeon, if obtainable, and, as soon as the affected person is secure, assess the extent of the damage. He mentioned contemplate putting a tourniquet if one will not be already in use and bear in mind the appliance instances.
“It is strongly recommended to position your time whenever you positioned your tourniquet on a whiteboard or one thing alongside these traces, so that you perceive how lengthy the affected person’s limb has been ischemic,” Melnic mentioned.
He mentioned surgeons need to have proximal management if the damage is arterial and distal management if the damage is venous.
If performing surgical procedure in an ASC, Melnic mentioned to verify the affected person is secure and apply a tourniquet. Previous to switch to a hospital setting, the surgeon ought to name the vascular surgeon to ask if there may be something that ought to be executed, in response to Melnic.
“Particularly to surgical facilities … you will need to do not forget that vascular surgeons are sometimes not current and sometimes will be 45 minutes to 1 hour away,” Melnic mentioned. “It’s key and very important to have a plan arrange at your surgical procedure heart what to do if the uncommon event this does occur. How are you going to handle it and the way is the affected person going to do OK and be capable to switch to an outdoor hospital, if crucial.”
Sources/Disclosures
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Melnic C. Symposium I: handle intraoperative problems throughout major TKA. Introduced at: American Affiliation of Hip and Knee Surgeons Annual Assembly; Nov. 8-10, 2024; Dallas.
Disclosures:
Melnic experiences no related monetary disclosures.
