医源性假性动脉瘤发生于膝关节镜手术后：临床表现、损伤血管、治疗及结局的系统综述
简介
这项系统综述最终汇总56篇报告、62例关节镜膝关节术后医源性假性动脉瘤病例；按互斥的主要手术分类，半月板手术占25/62例（40.3%），ACL相关手术占19/62例（30.6%），最常受累的血管为腘动脉（26/62，41.9%），其次为膝内侧/膝下动脉支（9/62，14.5%）。在49例可量化血管诊断间隔的病例中，中位时间为14天（范围1–365天），另有…
英文摘要
Pseudoaneurysm after arthroscopic knee procedures is uncommon but clinically important because it can initially resemble routine postoperative swelling, hematoma, recurrent hemarthrosis, deep vein thrombosis, infection, or compartment syndrome. PubMed, Embase, and Scopus were searched through July 9, 2026. The original database pathway yielded 312 records and 54 included reports representing 60 patient cases. During peer-review citation audit, three additional potentially eligible reports were identified; two full texts were retrieved and included, while one report could not be retrieved and was not used for patient-level inference. The final synthesis therefore included 56 reports and 62 patient cases. Using a mutually exclusive primary-procedure classification, meniscal procedures accounted for 25/62 cases (40.3%) and anterior cruciate ligament (ACL)-related procedures for 19/62 (30.6%). The popliteal artery was the most frequent injured-vessel group (26/62, 41.9%), followed by medial/inferior genicular branches (9/62, 14.5%). Among 49 cases with an explicitly quantifiable interval to vascular diagnosis or recognition, the median was 14 days (range: 1-365 days); 13 cases had missing or non-quantifiable timing. Primary treatment was open vascular surgery in 30 cases, endovascular embolization/coiling in 14, ultrasound-guided thrombin injection in six, covered-stent or other endovascular repair in five, conservative observation in two, an unspecified vascular approach in four, and no definitive pseudoaneurysm-directed treatment was reported in one. Fasciotomy and other adjunctive procedures were coded separately. Final outcome categories were favorable recovery/resolution without persistent morbidity in 42 cases, persistent neurologic/functional morbidity or incomplete recovery in four, limited or short-term follow-up in 10, and no outcome reported in six. These frequencies describe published cases only and cannot estimate incidence, risk, or comparative treatment effectiveness. Recurrent or progressive postoperative symptoms, a pulsatile finding, neurologic change, or symptoms out of proportion to the expected course should prompt consideration of vascular imaging.