Recurrent hemarthrosis after total knee arthroplasty

Worland, Richard L.; Jessup, Douglas E.

doi:10.1016/s0883-5403(96)80144-6

Cited by 69 publications

(47 citation statements)

References 3 publications

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“…Recurrent hemarthroses after a TKA are uncommon, reported to occur in less than 1% of patients [9,13,21]. As seen with our patient, a hemarthrosis can be a source of considerable pain and restricted motion.…”

Section: Discussionsupporting

confidence: 65%

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Recurrent Hemarthroses After TKA Treated With an Intraarticular Injection of Yttrium-90

Fine

Klestov

2016

Clinical Orthopaedics &Amp; Related Research

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Background Recurrent hemarthroses after a TKA are uncommon and usually respond to nonoperative treatment or intervention using angiographic embolization or synovectomy. However, in rare circumstances, the problem can be resistant to treatment. Case Description We report the case of a patient who had recurrent hemarthroses after a TKA. During the first 18 months after surgery, the patient experienced 48 episodes consistent with bleeding into the knee. The bleeding episodes recurred despite use of traditional treatments, including arthroscopy, open synovectomy and embolization of a small, false aneurysm. The patient ultimately received an intraarticular injection of yttrium-90 silica/citrate, and the hemarthroses ceased soon after the injection. At last review, 25 months after the injection, the patient had experienced no additional bleeding episodes. Literature Review On review of the literature, we found only one other report in which yttrium-90 was used successfully in a similar situation. Clinical Relevance Yttrium-90 may be considered a treatment option in patients with recurrent hemarthroses after TKA, especially when the condition has not responded to more traditional treatments. The long-term risk of treatment with yttrium-90 for recurrent hemarthroses after a TKA remains unclear.

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Section: Discussionsupporting

confidence: 65%

“…Recurrent hemarthroses of the knee are uncommon after a TKA, occurring in less than 1% of patients [9,13,21]. They can occur with varying frequency and result in knee pain, stiffness, and disability.…”

Section: Introductionmentioning

confidence: 99%

Recurrent Hemarthroses After TKA Treated With an Intraarticular Injection of Yttrium-90

Fine

Klestov

2016

Clinical Orthopaedics &Amp; Related Research

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“…The incidence has been reported to be from 0.3% 1 to 0.5%. 2 In our series of primary total knee arthroplasties on up to 1000 cases, this is the first case of hemoarthrosis. The incidence is considered to be 0.1% in our series, which is compatible with previous reports.…”

Section: Discussionmentioning

confidence: 83%

A case of spontaneous hemoarthrosis after a total knee arthroplasty

et al. 2006

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A 63-year-old woman with osteoarthritis had undergone right total knee arthroplasty. Nineteen months later, the patient presented with a recurrent hemoarthrosis. Open arthrotomy revealed hypertrophic synovium with small clots in the suprapatellar pouch, but entrapment of synovial tissues could not be observed. Histological examination of the extirpated specimen showed fibrous hypertrophy of synovium. The patient has no symptoms 51 months after surgery.

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“…For hemarthrosis that recurs after total knee arthroplasty and that fails to improve with conservative treatment, open synovectomy has been recommended by some studies (1,5,6). Kindsfater and Scott (1) reported no recurrence in 14 of 15 knees, and Worland and Jessup (5) found no recurrence in any of seven knees. Open synovectomy thus has a good postoperative outcome but entails problems such as the risk of infection and time required for rehabilitation.…”

Section: Discussionmentioning

confidence: 99%