Angiographic findings and therapeutic embolization of late hemarthrosis after total joint arthroplasty (original) (raw)
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Recurrent Hemarthrosis Following Knee Arthroplasty Treated with Arterial Embolization
The Journal of Arthroplasty, 2015
Recurrent hemarthrosis is an uncommon but troublesome complication following knee arthroplasty. This study reports the results for 13 patients with spontaneous recurrent hemarthrosis after knee arthroplasty treated with arterial embolization. The average interval between arthroplasty and embolization was 47 months (range, 2-103 months), and the average time from onset of hemarthrosis to embolization was 4.1 months (range, 1-11 months). Geniculate arterial embolization lead to resolution of hemarthrosis in 12 of 13 patients (92.3%). The one clinical failure likely represented a case of misdiagnosed periprosthetic joint infection. Two patients experienced transient cutaneous ischemia related to distal particulate embolization that resolved spontaneously. Selective geniculate arterial embolization is an effective and safe treatment modality for recurrent hemarthrosis after knee arthroplasty.
Successful Selective Embolization for Recurrent Hemarthrosis after Knee Arthroplasty
Case Reports in Orthopedics, 2019
Knee replacement has demonstrated to be a cost-effective treatment for severe knee osteoarthritis. Nevertheless, perioperative complications may occur, including recurrent hemarthrosis reaching an incidence between 0.3 and 1.6%. Success rate after conservative treatment has been reported to be above 80%, but in case of recurrence, computed tomography angiography, magnetic resonance angiography, and Doppler ultrasound have been used to conduct the diagnosis. Arthroscopy or selective embolization is used for treatment depending on the etiology of the bleeding. Open surgery is performed in the rare cases of failure of the above alternatives. The patient consulted seven months after total knee arthroplasty with sudden pain in the medial side of the knee. Infection was ruled out, and arthrocentesis shows hemarthrosis. Successful selective embolization of medial superior and lateral superior genicular artery was performed. After two years, the patients report 92 points in the Forgotten jo...
The Journal of Arthroplasty, 2008
A case of spontaneous recurrent hemarthrosis-due to developed hypertrophied synovium-after total knee arthroplasty is reported. The patient was successfully treated with radiosynovectomy. The first hemorrhage occurred 18 months after the total knee arthroplasty. Several similar episodes followed over a period of 4 years. Because conservative treatment failed to control the bleeding, an arthroscopic lavage was performed, which revealed the existence of proliferative synovium. A significant part of the hypertrophic tissue was excised with the use of a thermocoagulator. However, 1 month later, another episode of hemarthrosis occurred. As a final step before reoperation, the patient was treated with intra-articular injection of ytrium 90. Eighteen months later, she remains symptom-free, is very satisfied with the result, and reports no new episode of hemarthrosis.
Recurrent Hemarthrosis After Total Knee Arthroplasty
Arthroplasty Today, 2021
Recurrent hemarthrosis is a rare complication after total knee arthroplasty (TKA). Its incidence is reported as less than 1%. Most patients present with acute knee pain and swelling in the absence of trauma, resulting in significant loss of function. The authors report a case of recurrent hemarthrosis in a 64-yearold female. She presented with repeated episodes of sudden-onset right knee pain, swelling, and bruising at 18 months after a right TKA. During revision knee surgery, the recurrent hemarthrosis was identified to have been caused by entrapment of hypertrophied knee synovium under the TKA tibial base plate. After excision of the synovial tissue and cementing of the tibial defect, the patient recovered well after surgery with no future recurrences of knee pain and swelling.
Therapeutic embolization in the treatment of recurrent haemarthrosis following knee arthroplasty
Anz Journal of Surgery, 2010
Recurrent spontaneous haemarthrosis after knee arthroplasty occurs in less than 1% of cases, commonly thought to be the result of impingement of hypertrophic vascular synovium or fat pads, and exacerbated by anti-coagulation or anti-platelet therapy. Traditional treatment comprises an initial period of rest followed by open or arthroscopic washout, and by synovectomy if bleeding recurs or fails to settle. We present three cases of recurrent haemarthrosis following knee arthroplasty, which were successfully treated by angiography and feeding vessel coil embolization. An injury to one of the genicular arteries was identified as the cause of bleeding in all three cases; one manifest as a traumatic arteriovenous fistula. Bleeding ceased in all cases without recurrence (follow-up period 6 months-5 years, median of 2 years). Endovascular treatment offers a minimally invasive treatment option in selected cases of recurrent post-operative haemarthrosis.
International Journal of Medical and Pharmaceutical Case Reports, 2017
Introduction: Routinely patients with hip or knee arthroplasty are transferred from acute clinic to rehabilitationdepartment at an ever earlier stage (one week post-op). The most frequent complications after lower extremity arthroplasty are: local pain, edema, contracture, tardive calcification, infection, hemorrhage, pulmonary embolism and deep vein thrombosis. Sometimes unexpected complications can provoke a delay or even suspension of the rehabilitation. Aims of the Study: The principal objective of the current article is to remind to the wide public the possible presence (and subsequent care) of other complications, e.g. the lower limb arteritis. Case Presentation: The presented patient is 77 years old male. Hospitalized in our PRM Department one week after operation, with the objective of post-op orthopedic rehabilitation after total knee arthroplasty (for advanced gonarthrosis-genu varum with angle 4°). Arterial Echo-Doppler of the lower extremities: Acute thrombosis of the left femoral superficial arteria, and the left popliteal supra-articular arteria (aneurysm of 30 mm), missing images of retro & supra-articular
Short-Term Coagulation Complications Following Total Knee Arthroplasty
The Journal of Arthroplasty, 2011
Data from 3278 patients from a prospective patient-centered total joint registry was used to investigate the rates of complications in the first 6 months following primary total knee arthroplasty. All patients reporting deep venous thrombosis (DVT), pulmonary embolism (PE), or major bleeding were identified through patient self-reporting. Complications were verified by a review of imaging records and direct communication with patients by a surgeon. Surgeon-verified rates of DVT, PE, and major bleeding were 1.52%, 0.49%, and 0.34%, respectively. When compared with the complication rates as reported by patients, concordance was 86.2% for DVT, 84.2% for PE, and 36.7% for major bleeding. More than half (54.5%) of the complications were diagnosed and treated at the original operative hospital, and 45.5% were diagnosed and treated at other institutions. Keywords: total knee arthroplasty, complications, deep vein thrombosis, pulmonary embolism, major bleeding, registry.
Spontaneous arteriorrhexis in affected lower limb following total knee arthroplasty
Chinese journal of traumatology = Zhonghua chuang shang za zhi / Chinese Medical Association, 2008
Total knee arthroplasty (TKA) is now a standard treatment for serious osteoarthritis all over the world. Although it is a standard treatment, it has many complications, among which deep vein thrombosis (DVT) is the exclusive blood vessel complication that has been reported. However, we found a new blood vessel complication of TKA in this study, which is spontaneous arteriorrhexis in the affected lower limb.
Acute Arterial Thrombosis After Bilateral Total Knee Arthroplasty
The Journal of Arthroplasty, 2008
Arterial thrombosis is a rare complication of total knee arthroplasty (TKA). The overall incidence of arterial complications after TKA, including arterial occlusion, arteriovenous fistula, arterial aneurysm, and arterial severance, varies between 0.03% and 0.17% in reports published in the orthopedic literature (J Vasc Surg 1994;20:927-932). We report a case of acute popliteal artery thrombosis and its sequelae immediately following bilateral TKA performed sequentially under the same anesthesia. This is the first reported case of a post-TKA popliteal artery thrombosis in a patient younger than 60 years without the commonly accepted risk factors.