Recurrent hemarthrosis after unicompartmental knee arthroplasty

Area of Science:

• Orthopedic Surgery
• Biomedical Engineering
• Rheumatology

Background:

• Recurrent hemarthrosis post-knee arthroplasty poses significant challenges to patient recovery and joint function.
• Commonly, synovial impingement is implicated, necessitating prompt diagnosis and intervention.

Observation:

• A 66-year-old female patient experienced recurrent hemarthrosis 18 months after unicompartmental knee arthroplasty (UKA).
• Initial arthrotomies revealed hematoma but no prosthesis loosening or clear hemorrhage source; hyperplastic synovium was noted without impingement.
• Despite conservative measures and two surgical explorations, hemarthrosis persisted.

Findings:

• Open synovectomy was performed due to persistent, unexplained recurrent hemarthrosis.
• Histological examination showed hyperplastic synovium with hemosiderin pigmentation, but no signs of pigmented villonodular synovitis or mechanical impingement.
• The patient remained symptom-free for two years post-synovectomy.

Implications:

• Open synovectomy can be an effective treatment for recurrent hemarthrosis after UKA when conservative methods fail and impingement is not evident.
• This case expands the understanding of hemarthrosis etiology post-arthroplasty, suggesting synovial pathology as a key factor.
• Further research into the specific mechanisms of synovial hyperplasiain this context is warranted.