Study Pegs Rate of Geniculate Artery Injury During TKA

Thirty eight percent of patients will have an injury of a geniculate artery.

That’s one of the findings of new research from the Mayo Clinic.

Researchers from Mayo Clinic wanted to dig into what happens when the geniculate artery (GA) is injured, when the injury occurs, and any associations with tourniquet use.

Their work, “Geniculate Artery Injury During Primary Total Knee Arthroplasty,” appears in the October 29, 2018 edition of the American Journal of Orthopedics.

The authors wrote, “From November 2015 to February 2016, 3 surgeons at a single institution performed 100 consecutive primary TKAs and documented the presence or absence and the timing of GA injury. The data were then retrospectively reviewed. All TKAs had no prior surgery on the operative extremity. Other variables collected included tourniquet use, tranexamic acid (TXA) administration, intraoperative blood loss, postoperative drain output, and blood transfusion.”

“During total knee arthroscopy (TKA), 38% of patients will have an injury of a geniculate artery. The lateral inferior geniculate artery is most commonly injured, with a rate of injury of 31%. The middle geniculate artery is injured 15% of the time. The most common time of geniculate artery injury is during bone cutting or removal of the meniscus. There is no difference in rate of geniculate artery injury identification with or without the use of a tourniquet.”

Co-author Robert T. Trousdale, M.D. commented to OTW,“As many surgeons have decreased their use of the tourniquet we noticed it was not uncommon to see geniculate bleeding. Our results indicate that it is not uncommon to have geniculate bleeding and injury during a TKA. Our recommendation is that surgeons look for geniculate bleeding with tourniquet down and coagulate them if they are bleeding.”