Atraumatic haemarthrosis following total knee replacement treated with selective embolisation

Area of Science:

• Orthopedic surgery
• Vascular radiology
• Medical case reports

Background:

• Spontaneous haemarthrosis is an uncommon complication following total knee arthroplasty (TKA).
• This complication typically occurs in patients with underlying bleeding disorders or those on anticoagulant therapy.
• This report details a rare case of recurrent spontaneous haemarthrosis post-TKA without these risk factors.

Observation:

• A 69-year-old patient presented with recurrent spontaneous haemarthrosis after a total knee replacement.
• Diagnostic angiography revealed abnormal vascularity around the anterior knee joint.
• The abnormal vessels were supplied by genicular branches and a recurrent branch of the anterior tibial artery.

Findings:

• Angiography successfully identified the source of bleeding in recurrent spontaneous haemarthrosis after TKA.
• Selective embolisation of the identified abnormal vessels provided immediate and effective control of the bleeding.
• The patient experienced no further episodes of haemarthrosis post-embolisation.

Implications:

• This case highlights the utility of angiography in diagnosing the cause of spontaneous haemarthrosis after TKA.
• Vascular embolisation is a viable and effective treatment option for managing this rare complication.
• Early diagnosis and intervention can prevent recurrent bleeding and improve patient outcomes following total knee arthroplasty.