在全膝关节关节整形术中受伤的风险与解剖学变异有关:一个范围审查
Hiren Parekh1, Bohdanna Zazulak2, Adam V Daniel3
1Yale College, Yale University, New Haven, CT, USA.
Arthroplasty today
|March 5, 2026
概括
脊柱动脉 (PA) 的解剖学变异是膝盖全关节整形术 (TKA) 期间血管损伤的危险因素. 在手术前了解这些PA异常可以帮助减少严重并发症.
科学领域:
- 血管外科 血管外科
- 整形外科手术 整形外科手术
- 人体解剖学 解剖学 解剖学
背景情况:
- 在膝关节全关节整形术 (TKA) 期间,尾动脉 (PA) 的损伤很少见,但可能导致严重的并发症.
- 解剖学变异,如高PA分叉或异常的前额关动脉 (ATA),增加了血管损伤的风险.
- 术前识别这些变体对于减少手术并发症至关重要.
研究的目的:
- 评估PA解剖变异的流行情况.
- 评估这些变体对TKA的相关性.
- 确定相关的血管并发症,并假设异常的动脉解剖学增加了风险.
主要方法:
- 在EMBASE,MEDLINE和Scopus中进行了系统的文献搜索.
- 研究被选为相关的PA变化,患病率,或TKA相关的血管并发症.
- 数据提取集中在解剖学发现,成像和外科手术结果上,遵循PRISMA-ScR指南.
主要成果:
- 11项研究符合纳入标准,包括4例TKA期间血管损伤的病例报告在异常PA解剖的患者中.
- 在成像研究中,异常ATA的患病率在0.4%至6%之间,在一项MRI研究中发现了3.2%的患病率.
- 高PA分叉和变异性ATA起源被确定为危险因素,女性受伤风险增加.
结论:
- 脊柱动脉的解剖学变异可能是TKA期间血管损伤的未被认可的风险因素.
- 对解剖学变异的认识,加上对MRI和选择性血管成像的仔细审查,可以改善手术规划.
- 积极识别和管理PA异常可以帮助减轻严重的术后并发症.
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