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Updated: Jan 29, 2026

Reverse Total Shoulder Arthroplasty
Published on: July 5, 2011
Recurrent Hemarthrosis After Total Knee Arthroplasty: Evaluation and Treatment
Bheeshma Ravi1, Luke Hosack, David Backstein
1From the Division of Orthopaedic Surgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada (Dr. Ravi and Dr. Backstein), the Division of Orthopaedic Surgery, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada (Dr. Ravi and Dr. Hosack), the Klamath Orthopaedic Clinic, Klamath Falls, OR (Dr. Hosack), the Division of Orthopaedic Surgery, Mount Sinai Hospital, Toronto, Ontario, Canada (Dr. Backstein), and the Department of Orthopaedic Surgery, Mayo Clinic, Phoenix, AZ (Dr. Spangehl).
Abstract:
Recurrent hemarthrosis (RH) is a rare complication (∼1%) after total knee arthroplasty (TKA). It is a complex and particularly frustrating problem for both patient and surgeon. Typically, patients present several months to years after their index TKA surgery with a painful and swollen joint. Although conservative management may provide temporary relief, the rate of recurrence is high. Despite extensive case series in the literature, no consensus was made on the criteria needed to establish this diagnosis, or how to best provide treatment. Several management strategies have been described for RH, including immobilization, arthroscopic versus open synovectomy, angiographic embolization, and revision arthroplasty. All of these have demonstrated variable effectiveness, with limited evidence for their use in specific situations. This review synthesizes the available literature and suggests an algorithm for the diagnosis and treatment of RH after TKA.
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