Recurrent hemarthrosis after total knee arthroplasty

Recurrent Hemarthrosis Following Knee Arthroplasty Treated with Arterial Embolization

“…The patients in our series had an average interval of 3.9 years between their index procedure and symptoms. Three other studies demonstrated an interval of about two years after surgery until the onset of hemarthrosis [1,2,4]. In our group of thirteen patients, three presented within the first postoperative year.…”

“…Kindsfater and Scott reported that nine out of their series of thirty patients had resolution of symptoms with conservative care alone, while Ohdera et al showed success in three out of their ten patients with aspiration and immobilization [2,4]. Arthroscopic or open synovectomy has traditionally been the mainstay of surgical treatment when conservative measures fail.…”

“…The time of onset of recurrent hemarthrosis has been reported to be an average of two years after surgery; however, cases have been reported up to 18 years after surgery [1,2,4,5]. While the etiology is poorly understood, the most accepted explanation for spontaneous hemarthrosis is entrapment of synovial tissue or fat pad between the prosthetic surfaces, or repetitive trauma to hypertrophic vascular synovium [1,2,4]. No obvious etiology may be identifiable in a large percentage of cases.…”

“…Patients taking anticoagulant medication may be advised to stop these medicines for a period of time if the risks for the individual patient are acceptable. If these measures do not resolve the patient's symptoms, an open or arthroscopic synovectomy was the recommended treatment option for a number of years [2,4]. Recently, arterial embolization has been described in a small number of cases as a novel method to treat recurrent hemarthrosis without the morbidity of surgical intervention [5][6][7][8][9].…”

A case of spontaneous hemoarthrosis after a total knee arthroplasty

“…The incidence is considered to be 0.1% in our series, which is compatible with previous reports. In 1995, Oishi et al 1 and Kindsfater et al 3 reported the entity of recurrent hemoarthrosis. Fifty-three cases 1-9 of recurrent hemoarthrosis have been reported, except cases of pigmented villonodular synovitis, 10 hemophilia, 16 and implant failure 11 (Table 1).…”