Knee Surg Relat Res.  2018 Dec;30(4):364-368. 10.5792/ksrr.18.039.

Pseudoaneurysm Formation due to Popliteal Artery Injury Caused by Drilling during Medial Opening Wedge High Tibial Osteotomy

• Chun KC
• So BJ
• Kang HT
• Chun CH

• KMID: 2438118
• DOI: http://doi.org/10.5792/ksrr.18.039

Abstract

We report a case of 53-year-old woman with an injured popliteal artery due to excessive drilling with a drill bit during medial opening wedge high tibial osteotomy (MOWHTO). Pseudoaneurysm was diagnosed three days after surgery and confirmed by urgent computed tomography (CT) angiography. Open vascular surgery with resection of the perivascular hematoma and end-to-end anastomosis using ipsilateral saphenous vein interposition graft was performed. CT angiography at 8 months postoperatively showed that blood flow was maintained without obstruction of the graft site and active dorsiflexion of the foot was possible. To reduce neurovascular injury during MOWHTO, it is important not to drill the far cortex at the proximal part of the osteotomy site when using a drill bit, and the metal should be positioned posteromedially as much as possible.

Keyword

Knee; Osteotomy; Popliteal artery; Pseudoaneurysm

MeSH Terms

Aneurysm, False*
Angiography
Female
Foot
Hematoma
Humans
Knee
Middle Aged
Osteotomy*
Popliteal Artery*
Saphenous Vein
Transplants