Premium
Therapeutic embolization in the treatment of recurrent haemarthrosis following knee arthroplasty
Author(s) -
TatSing Law Michael,
McClure David N.
Publication year - 2010
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/j.1445-2197.2010.05244.x
Subject(s) - medicine , surgery , embolization , hemarthrosis , synovectomy , angiography , arterial embolization , arthroplasty , radiology , rheumatoid arthritis
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.