Therapeutic embolization of the genicular arteries for recurrent hemarthrosis after total knee arthroplasty

Is Embolization an Effective Treatment for Recurrent Hemorrhage After Hip or Knee Arthroplasty?

“…Other limitations include the relatively short followup (minimum of 1 year), which leaves open the possibility that these hemarthroses can recur, and the heterogeneity of the patient population in terms of diagnoses and presentations, which are typical of the condition, in our experience. During the last decade, case reports and other series reported satisfying results after transarterial embolization [1,3,5,7,9]. We found that transarterial embolization was well-tolerated and effective in six of seven patients; this tends to confirm and extend that experience.…”

Selective arterial embolization with gelatin particles for refractory knee hemarthrosis

“…Sizes of particles chosen were 150-250 or 250-350 μm for PA and 500-700 μm for TAGM. Genicular arterial branches and/or the supra-articular popliteal artery were target arteries selectively embolized (4,(7)(8)(9)(10)(11)(12)(13)(14). In all cases reported, embolization was technically successful, with no clinical recurrence except for one.…”

“…In addition to surgical methods, case reports in which knee hemarthrosis was successfully treated by transarterial embolization, which is less invasive, have been published as listed in Table 2 (4,(7)(8)(9)(10)(11)(12)(13)(14). All but one of these reports describe treatment for recurrent hemarthrosis after total knee arthroplasty.…”

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

“…The most frequent reported causes of recurrent bleeding into the knee are entrapped proliferative synovial tissue or the fat pad caught between prosthetic components [9]. Other reported causes include tumors [3], retained meniscal fragments [7], pigmented villonodular synovitis [2], vascular causes (aneurysms, pseudoaneurysms, arteriovenous fistulae) [5,6,14,15,18], hematologic conditions [11], use of anticoagulants, or mechanical factors causing repetitive minor trauma such as malalignment, instability, and malposition of the implants [16]. In more than 50% of cases, no cause for bleeding is found [9].…”