Recurrent hemarthrosis after knee joint arthroplasty

Ohdera, Toshihiro; Tokunaga, Mikio; Hiroshima, Shiro; Yoshimoto, Eiji; Matsuda, Shingo

doi:10.1016/j.arth.2003.09.009

Cited by 73 publications

(88 citation statements)

References 10 publications

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“…The most common surgical and histologic findings of hemarthrosis occurring late after total knee arthroplasty include hypervascular and proliferative synovium with signs of arthroplasty component impingement, which is more prone to trauma and more likely to bleed (65). Iatrogenic causes such as pseudoaneurysms or arteriovenous fistulas manifest most frequently within the first 6 months after surgery.…”

Section: Recurrent Hemarthrosismentioning

confidence: 99%

MR Imaging of Knee Arthroplasty Implants

Fritz¹,

Lurie²,

Potter³

2015

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121

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Primary total knee arthroplasty is a highly effective treatment that relieves pain and improves joint function in a large percentage of patients. Despite an initially satisfactory surgical outcome, pain, dysfunction, and implant failure can occur over time. Identifying the etiology of complications is vital for appropriate management and proper timing of revision. Due to the increasing number of knee arthroplasties performed and decreasing patient age at implantation, there is a demand for accurate diagnosis to determine appropriate treatment of symptomatic joints following knee arthroplasty, and for monitoring of patients at risk. Magnetic resonance (MR) imaging allows for comprehensive imaging evaluation of the tissues surrounding knee arthroplasty implants with metallic components, including the polyethylene components. Optimized conventional and advanced pulse sequences can result in substantial metallic artifact reduction and afford improved visualization of bone, implant-tissue interfaces, and periprosthetic soft tissue for the diagnosis of arthroplasty-related complications. In this review article, we discuss strategies for MR imaging around knee arthroplasty implants and illustrate the imaging appearances of common modes of failure, including aseptic loosening, polyethylene wear-induced synovitis and osteolysis, periprosthetic joint infections, fracture, patellar clunk syndrome, recurrent hemarthrosis, arthrofibrosis, component malalignment, extensor mechanism injury, and instability. A systematic approach is provided for evaluation of MR imaging of knee implants. MR imaging with optimized conventional pulse sequences and advanced metal artifact reduction techniques can contribute important information for diagnosis, prognosis, risk stratification, and surgical planning.

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Section: Recurrent Hemarthrosismentioning

confidence: 99%

MR Imaging of Knee Arthroplasty Implants

Fritz¹,

Lurie²,

Potter³

2015

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121

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“…surgery have been reported, including infection, 9,10 pulmonary embolism, 11,12 thromboses, 11,[13][14][15] fat embolism, 16 hemarthrosis, 17 patellar fracture, 18 heterotopic ossification, 19,20 stiffness, 21,22 nerve damage, 11,23 vascular injuries, 11,14,24,25 and urinary complications. 11,12 The perioperative mortality rate has been reported at 0.17%-0.46% for primary total knee arthroplasty within 90 days [26][27][28] and 0.33%-0.78% for bilateral knee replacements within 30 days.…”

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confidence: 99%

Total Knee Replacement Delayed With Hylan G-F 20 Use in Patients With Grade IV Osteoarthritis

Waddell¹,

Bricker²

2007

JMCP

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steoarthritis (OA) and other rheumatic conditions are the leading cause of disability in the United States. 1 The prevalence of OA of the knee in various countries can be estimated as 18% of men and women as inferred by a recent meta-analysis.2 OA can also result in significant direct and indirect costs, which are higher with greater disability. 3 Current therapeutic options for OA are approved to treat the pain associated with the disorder. The American College of Rheumatology recommends the initial use of nonpharmacologic techniques, such as patient education, weight loss, and physical therapy, followed by pharmacologic therapies such as acetaminophen and cyclooxygenase (COX)-2-specific inhibitors. 4 Intra-articular hyaluronan therapy is recommended for patients who are no longer responsive to nonpharmacologic and pharmacologic treatments or who may be experiencing adverse side effects with nonselective nonsteroidal inflammatory drugs or COX-2-specific inhibitors. 4 Total knee replacement (TKR) is considered a last resort for treatment of OA knee pain in appropriate patients when other therapies fail. According to the National Hospital Discharge Survey published by the U.S. Department of Health & Human Services, approximately 326,000 patients in the United States received a TKR in 2001. 5 In a sample of 6,856 decedents aged ≥65 years, 2.1% were found to have received knee replacements. 6 The cost of knee replacement surgery at patient discharge was reported as $24,045 for 2001. 7 The success of TKR in most patients has been supported by more than 20 years of follow-up data. 8 While TKR is an effective option for OA pain relief for many patients, it is not medically desirable for some patients (age, heart disease, diabetes, pulmonary disease, obesity, or generalized medical debilitation) or is not preferred by others. Additionally, complications of the ABSTRACT BACKGROUND: Total knee replacement (TKR), a last resort for treating knee pain due to osteoarthritis (OA), is not always medically indicated or preferred by many patients. Hylan G-F 20 is a cross-linked hyaluronan derivative approved for the treatment of pain due to OA of the knee after other conservative approaches have failed.OBJECTIVE: The objectives of this study were to (1) determine the effect of hylan G-F 20 on patient need for TKR as measured by time from hylan G-F 20 injection to TKR, and (2) assess patient factors that might influence time from hylan G-F 20 therapy to TKR.METHODS: This is a retrospective case series review of the medical records of patients seen in 1 orthopedic specialty practice. The incidence and time to TKR in patients who were TKR candidates (100% grade IV OA [severe]) treated with 1 or more courses of intra-articular hylan G-F 20 injections (3 weekly injections per course) were determined from October 1997 to November 2003. Survival analysis was used to evaluate time to TKR and the effects of age, gender, ethnicity, body mass index (BMI), and presence of effusion on this outcome. Logistic regression was also used to assess...

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“…Open synovectomy ensures reliable hemostasis but is highly invasive. Arthroscopic synovectomy is less invasive but may result in the recurrence of hemarthrosis (3). In addition to surgical treatment, in recent years, arterial embolization has been reported to be a less invasive method of treatment (4).…”

Section: Resultsmentioning

confidence: 99%

“…Arthroscopic synovectomy has the advantages of a small incision, little bleeding, and short postoperative rehabilitation. However, Ohdera et al (3) reported that, although healing occurred in two of six knees for which arthroscopic synovectomy combined with electric coagulation was performed, the condition recurred in the other four knees, and healing did not occur until open synovectomy was performed. This suggests the need for caution concerning recurrence after arthroscopic treatment.…”

Section: Discussionmentioning

confidence: 99%