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Delayed diagnosis of a pseudoaneurysm with recurrent hemarthrosis of the knee joint

Christoph Becher1, Ulrike L Burger, Jens R Allenberg

  • 1Department of Orthopaedic Surgery, Phillips University Marburg, Baldinger Strasse, 35043, Marburg, Germany. becher.chris@web.de

Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA
|February 29, 2008
PubMed

Insights

Recurrent knee joint hemarthrosis in a 47-year-old male was successfully treated by embolizing a pseudoaneurysm of the superior middle genicular artery. This case highlights a rare cause of persistent bleeding after knee procedures.

Area of Science:

  • Orthopedic Surgery
  • Interventional Radiology
  • Vascular Medicine

Background:

  • Recurrent hemarthrosis of the knee joint can be a debilitating condition.
  • Previous treatments for suspected infection, including arthroscopic synovectomy and joint punctures, failed to resolve the bleeding.
  • Hyaluronic acid injections preceded the initial symptoms, raising diagnostic challenges.

Observation:

  • A 47-year-old male presented with persistent knee hemarthrosis over three months.
  • Multiple prior arthroscopic procedures and joint aspirations were performed without resolution.
  • Diagnostic imaging revealed a pseudoaneurysm of the superior middle genicular artery.

Findings:

  • The pseudoaneurysm was identified as the source of recurrent bleeding.
  • Selective angiographic embolization effectively occluded the pseudoaneurysm.
  • The patient's hemarthrosis resolved following the embolization procedure.

Implications:

  • Pseudoaneurysm of the genicular artery is a potential, albeit rare, cause of recurrent knee hemarthrosis.
  • Angiographic embolization offers a minimally invasive and effective treatment option.
  • This case underscores the importance of considering vascular etiologies in refractory hemarthrosis.

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