Aortic abdominal aneurysm

Good morning

You have brought about an important issue today regarding orthopedic knee replacements with an AAA. Curious to know who is monitoring your aneurysm and it’s size. Mine is 5.9mm @ 81 yrs and my chiropractor will not treat me anymore because of possible rupture concerns.

Am not an expert to answer your excellent questions, but am including excerpts from the internet that might be helpful. It would be much better to have advice from a vascular surgeon treating your AAA , so a treatment plan can be discussed as a team with the orthopedic surgeon(s).

A bit technical…..
Increased Risk of Complications:
Knee replacement surgery, especially if involving the femoral artery, increases the risk of complications related to the aneurysm, such as rupture or pseudoaneurysm formation.
Surgical Strategy:
The surgical strategy for AAA and knee replacement needs to be carefully planned to minimize risks, potentially involving a staged approach or specialized techniques.
Vascular Surgeon Consultation:
In cases of AAA, a vascular surgeon should be consulted to assess the aneurysm's size, location, and risk of rupture, and to determine the safest course of action for both procedures.
Pre- and Post-operative Care:
Pre-operative management may involve aneurysm repair or stabilization, while post-operative care requires close monitoring for complications related to both the knee replacement and the AAA.
Not a Contraindication:
Knee replacement surgery is not a contraindication for patients with AAA, but careful evaluation and management are crucial to ensure the best possible outcome.

If a total knee replacement can't be performed due to an abdominal aortic aneurysm (AAA), treatment focuses on addressing the AAA first, potentially with endovascular repair or open surgery, followed by a delayed knee replacement once the AAA is stable.
Here's a more detailed explanation:
Prioritize AAA Treatment:
The primary concern is the AAA, which can be life-threatening if it ruptures.
Endovascular Repair:
This is often the preferred method, involving inserting a catheter with a stent-graft into an artery in the groin, guiding it to the aorta, and expanding the graft to strengthen the weakened area.
Open Surgery:
In some cases, open surgery is necessary, where the damaged aorta is removed and replaced with a graft.
Delayed Knee Replacement:
Once the AAA is successfully treated and the patient is stable, the knee replacement can be considered.
Other Considerations:
Physical Therapy: Physical therapy can help maintain strength and range of motion in the knee, even before surgery is an option.
Pain Management: Pain medication and other strategies can help manage pain until surgery is feasible.
Bracing and Orthotics: These can help support the knee and improve function.
Knee Gel Injections: These can help replace the lost lubrication in the knee joint when you have arthritis.
Cartilage Regeneration: For knees with a limited amount of arthritis and good alignment of the bones, doctors may be able to offer newer treatments that replace cartilage instead of replacing the entire joint.

Thanks for sharing your post…

Blessings!

Thank you for your in-depth reply. It is quite a "catch-22" isn't it! My vascular doctor says I need the open body surgery because the Endo surgery would instill a stent that would cover the celiac artery (which feeds most of the other organs). I am petrified of this operation due the percentage of deaths, paralysis, and other horrid medical issues is very high. So now I must live with not only a life threatening medical condition (AAA) and a life-changing condition (knee pain doing what I enjoy most in life). Have you heard much about stem cell injections for knee issues?