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Knee Arthrocentesis in Adults
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Recurrent Hemarthrosis After Total Knee Arthroplasty.

Samuel Seow Zi Jie1, Adrian Lau Cheng Kiang2, Dave Lee Yee Han3

  • 1Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore.

Arthroplasty Today
|June 18, 2021
PubMed
Summary

Recurrent hemarthrosis after total knee arthroplasty (TKA) is rare. This case highlights hypertrophied synovium entrapment as a cause, successfully treated with synovectomy and defect repair.

Keywords:
Recurrent haemarthrosisTotal knee arthroplasty

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Area of Science:

  • Orthopedic Surgery
  • Arthroplasty Complications
  • Knee Biomechanics

Background:

  • Recurrent hemarthrosis is an uncommon complication following total knee arthroplasty (TKA), affecting less than 1% of patients.
  • Patients typically experience acute knee pain, swelling, and functional decline without apparent trauma.

Observation:

  • A 64-year-old female presented with recurrent episodes of spontaneous right knee pain, swelling, and bruising 18 months post-TKA.
  • These symptoms significantly impacted her daily function and quality of life.

Findings:

  • Revision surgery revealed hypertrophied knee synovium entrapped beneath the tibial base plate of the TKA as the cause of recurrent bleeding.
  • Excision of the inflamed synovial tissue and repair of the tibial defect led to resolution.

Implications:

  • This case underscores the importance of considering synovial impingement in unexplained hemarthrosis after TKA.
  • Surgical intervention, including synovectomy and defect management, can effectively resolve this rare complication.
  • Early diagnosis and treatment are crucial for restoring function and preventing further joint damage.