{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T15:55:26Z","timestamp":1791215726108,"version":"4.1.0"},"reference-count":23,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T00:00:00Z","timestamp":1791158400000},"content-version":"vor","delay-in-days":4,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["esskajournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J. exp. orthop."],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Popliteal artery injury (PAI) around the knee is a limb\u2010threatening condition typically associated with high\u2010energy trauma, particularly multiligament knee injuries (MLKIs) and tibial plateau fractures. This study aimed to analyse injury patterns, management, complications and functional outcomes, with the hypothesis that fracture\u2010related PAI would be associated with better functional outcomes than MLKI\u2010associated PAI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective review was conducted of patients treated for PAI at a tertiary referral centre from 2003 to 2023. Patients were eligible if computed tomography angiography confirmed PAI associated with MLKI or a high\u2010energy tibial plateau fracture. Demographics, injury characteristics, surgical management and complications were recorded. Functional outcomes were assessed using the International Knee Documentation Committee (IKDC) score and visual analogue scale (VAS) for pain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Forty\u2010eight patients (mean age, 44.1 years; 68.7% male) were included: 36 with MLKIs and 12 with fracture\u2010related vascular injuries. Vascular procedures comprised popliteal bypass grafting in 30 patients (62.5%), venous patch angioplasty in 10 (20.8%) and primary arterial repair in 8 (16.7%). External fixation was applied to all patients. Peroneal nerve injury occurred in 15 patients (31.3%). Amputation was required in five patients (10.4%), all within the MLKI group and was associated with delayed presentation, advanced soft\u2010tissue compromise and neurovascular injury severity at the time of referral. At final follow\u2010up, the fracture group had higher IKDC scores (85.4 vs. 74.2;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.032) and lower VAS pain scores (2.39 vs. 3.47;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.049) than the MLKI group.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In this cohort, fracture\u2010related PAI was associated with better functional outcomes than MLKI\u2010associated PAI, whereas all amputations occurred in the MLKI group after delayed presentation and referral. These findings emphasize the importance of timely diagnosis, referral and coordinated vascular\u2013orthopaedic management.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>Level III, retrospective comparative study.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jeo2.70943","type":"journal-article","created":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T15:26:11Z","timestamp":1791213971000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Popliteal artery injury associated with multiligament knee injuries and tibial plateau fractures: A 20\u2010year retrospective cohort study"],"prefix":"10.1002","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8379-8593","authenticated-orcid":false,"given":"Efstathios","family":"Konstantinou","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery and Musculoskeletal Trauma, University Hospital of Larissa, School of Health Sciences University of Thessaly Larissa Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6784-6022","authenticated-orcid":false,"given":"Nikolaos","family":"Stefanou","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery and Musculoskeletal Trauma, University Hospital of Larissa, School of Health Sciences University of Thessaly Larissa Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina","family":"Arnaoutoglou","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery and Musculoskeletal Trauma, University Hospital of Larissa, School of Health Sciences University of Thessaly Larissa Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zoe","family":"Dailiana","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery and Musculoskeletal Trauma, University Hospital of Larissa, School of Health Sciences University of Thessaly Larissa Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sokratis","family":"Varitimidis","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery and Musculoskeletal Trauma, University Hospital of Larissa, School of Health Sciences University of Thessaly Larissa Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9494-6048","authenticated-orcid":false,"given":"Michael","family":"Hantes","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery and Musculoskeletal Trauma, University Hospital of Larissa, School of Health Sciences University of Thessaly Larissa Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,5]]},"reference":[{"issue":"10","key":"e_1_2_14_2_1","article-title":"Popliteal artery injury during total knee replacement: a single\u2010center experience","volume":"16","author":"Alsaleem M","year":"2024","journal-title":"Cureus"},{"issue":"2","key":"e_1_2_14_3_1","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1016\/j.ejvs.2020.10.017","article-title":"Incidence and outcome of popliteal artery injury associated with knee dislocations, ligamentous injuries, and close to knee fractures: a nationwide population based cohort study","volume":"61","author":"Bernhoff K","year":"2021","journal-title":"Eur J Vasc Endovasc Surg"},{"key":"e_1_2_14_4_1","unstructured":"Davis DD Shaw PM. Popliteal artery entrapment syndrome. In:StatPearls[Internet]. Treasure Island (FL): StatPearls Publishing; 2023."},{"issue":"12","key":"e_1_2_14_5_1","doi-asserted-by":"crossref","DOI":"10.1016\/j.injury.2025.112855","article-title":"Neurovascular injuries in tibial plateau fractures: rare in Schatzker IV, predominant in complex patterns","volume":"56","author":"Franulic N","year":"2025","journal-title":"Injury"},{"issue":"1","key":"e_1_2_14_6_1","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1016\/j.jvs.2019.09.048","article-title":"A propensity\u2010matched analysis of contemporary outcomes of blunt popliteal artery injury","volume":"72","author":"Futchko J","year":"2020","journal-title":"J Vasc Surg"},{"issue":"5","key":"e_1_2_14_7_1","doi-asserted-by":"crossref","first-page":"4169","DOI":"10.1007\/s00068-022-01961-8","article-title":"Iatrogenic injury of the popliteal artery in orthopedic knee surgery: clinical results and development of a therapeutic algorithm","volume":"48","author":"Gosslau Y","year":"2022","journal-title":"Eur J Trauma Emerg Surg"},{"issue":"6","key":"e_1_2_14_8_1","doi-asserted-by":"crossref","first-page":"1271","DOI":"10.1016\/j.knee.2019.08.009","article-title":"Long\u2010term clinical and radiological outcomes after multiligament knee injury using a delayed ligament reconstruction approach: a single\u2010center experience","volume":"26","author":"Hantes M","year":"2019","journal-title":"Knee"},{"key":"e_1_2_14_9_1","unstructured":"Huber GH Manna B. Vascular extremity trauma. In:StatPearls[Internet]. Treasure Island (FL): StatPearls Publishing; 2023."},{"issue":"5","key":"e_1_2_14_10_1","doi-asserted-by":"crossref","first-page":"600","DOI":"10.1177\/03635465010290051301","article-title":"Development and validation of the International Knee Documentation Committee subjective knee form","volume":"29","author":"Irrgang JJ","year":"2001","journal-title":"Am J Sports Med"},{"issue":"2","key":"e_1_2_14_11_1","doi-asserted-by":"crossref","first-page":"142","DOI":"10.20408\/jti.2022.0064","article-title":"Delayed diagnosis of popliteal artery injury after traumatic knee dislocation in Korea: a case report","volume":"36","author":"Lee CE","year":"2023","journal-title":"J Trauma Injury"},{"key":"e_1_2_14_12_1","unstructured":"Lezak B Massel DH Varacallo MA. Peroneal nerve injury. In:StatPearls[Internet]. Treasure Island (FL): StatPearls Publishing; 2024."},{"key":"e_1_2_14_13_1","unstructured":"Mohseni M Mabrouk A Simon LV. Knee dislocation. In:StatPearls[Internet]. Treasure Island (FL): StatPearls Publishing; 2024."},{"issue":"5","key":"e_1_2_14_14_1","doi-asserted-by":"crossref","first-page":"646","DOI":"10.4103\/njcp.njcp_778_22","article-title":"Direct thermal injury to the popliteal artery after total knee arthroplasty","volume":"26","author":"Moon S","year":"2023","journal-title":"Niger J Clin Pract"},{"issue":"9","key":"e_1_2_14_15_1","doi-asserted-by":"crossref","first-page":"2615","DOI":"10.1007\/s11999-014-3566-1","article-title":"What is the frequency of vascular injury after knee dislocation?","volume":"472","author":"Natsuhara KM","year":"2014","journal-title":"Clin Orthop Relat Res"},{"issue":"3","key":"e_1_2_14_16_1","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1302\/2058-5241.5.190012","article-title":"Management of multiligament knee injuries","volume":"5","author":"Ng JWG","year":"2020","journal-title":"EFORT Open Rev"},{"issue":"11","key":"e_1_2_14_17_1","article-title":"Endovascular repair of a traumatic popliteal artery injury","volume":"14","author":"Nguyen A","year":"2022","journal-title":"Cureus"},{"issue":"5","key":"e_1_2_14_18_1","doi-asserted-by":"crossref","first-page":"1573","DOI":"10.1016\/j.jvs.2021.04.064","article-title":"Contemporary outcomes of traumatic popliteal artery injury repair from the popliteal scoring assessment for vascular extremity injury in trauma study","volume":"74","author":"O'Banion LA","year":"2021","journal-title":"J Vasc Surg"},{"issue":"7","key":"e_1_2_14_19_1","doi-asserted-by":"crossref","first-page":"1331","DOI":"10.2106\/00004623-197355070-00001","article-title":"Tibial condylar fractures. Impairment of knee joint stability as an indication for surgical treatment","volume":"55","author":"Rasmussen PS","year":"1973","journal-title":"J Bone Jt Surg Am"},{"key":"e_1_2_14_20_1","first-page":"94","article-title":"The tibial plateau fracture. The Toronto experience 1968\u22121975","volume":"138","author":"Schatzker J","year":"1979","journal-title":"Clin Orthop Relat Res"},{"key":"e_1_2_14_21_1","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1051\/sicotj\/2021058","article-title":"Current concepts in the assessment and management of multiligament injuries of the knee","volume":"7","author":"Scheepers W","year":"2021","journal-title":"SICOT\u2010J"},{"issue":"5","key":"e_1_2_14_22_1","doi-asserted-by":"crossref","first-page":"411","DOI":"10.5312\/wjo.v13.i5.411","article-title":"Update in combined musculoskeletal and vascular injuries of the extremities","volume":"13","author":"Stefanou N","year":"2022","journal-title":"World J Orthop"},{"issue":"2","key":"e_1_2_14_23_1","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1016\/j.ejvs.2024.12.018","article-title":"Editor's Choice\u2014European Society for Vascular Surgery (ESVS) 2025 Clinical Practice Guidelines on the Management of Vascular Trauma","volume":"69","author":"Wahlgren CM","year":"2025","journal-title":"Eur J Vasc Endovasc Surg"},{"key":"e_1_2_14_24_1","article-title":"Limb\u2010salvage outcomes of arterial repair beyond time limit at different lower\u2010extremity injury sites","volume":"27","author":"Yu L","year":"2021","journal-title":"Med Sci Monit"}],"container-title":["Journal of Experimental Orthopaedics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/esskajournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jeo2.70943","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/esskajournals.onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/jeo2.70943","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/esskajournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jeo2.70943","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T15:26:15Z","timestamp":1791213975000},"score":1,"resource":{"primary":{"URL":"https:\/\/esskajournals.onlinelibrary.wiley.com\/doi\/10.1002\/jeo2.70943"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10]]},"references-count":23,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026,10]]}},"alternative-id":["10.1002\/jeo2.70943"],"URL":"https:\/\/doi.org\/10.1002\/jeo2.70943","archive":["Portico"],"relation":{},"ISSN":["2197-1153","2197-1153"],"issn-type":[{"value":"2197-1153","type":"print"},{"value":"2197-1153","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10]]},"assertion":[{"value":"2026-04-01","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-23","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-05","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70943"}}