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Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function
Published on: March 15, 2022
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Predictive Variables for Interventional Angiography among Patients with Knee Hemarthrosis
Sang-Hun Ko1, Kwang-Hwan Jung1, Jae-Ryong Cha1
1Department of Orthopedic Surgery, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan 44033, Korea.
Diagnostics (Basel, Switzerland)
|April 23, 2022
Summary
High synovial red blood cell (RBC) counts in knee hemarthrosis indicate failed conservative treatment. Elevated RBCs in synovial fluid suggest a need for immediate interventional angiography over continued conservative management.
Area of Science:
- Orthopedic Surgery
- Sports Medicine
- Diagnostic Imaging
Background:
- Conservative treatment is common for knee hemarthrosis.
- Predictive factors for conservative treatment success in knee hemarthrosis are not well-established.
- Identifying early indicators of treatment failure is crucial for patient outcomes.
Purpose of the Study:
- To identify laboratory variables predicting the success of conservative treatment for knee hemarthrosis.
- To compare synovial fluid analysis in patients with successful versus failed conservative treatment.
Main Methods:
- Retrospective analysis of 29 patients with knee hemarthrosis.
- Patients divided into two groups: failed conservative treatment (Group A, n=14) requiring angiography/embolization, and successful conservative treatment (Group B, n=15).
- Evaluation of serological and synovial fluid test results, focusing on red blood cell (RBC) counts.
Main Results:
- Group A (failed treatment) showed significantly higher mean synovial RBC counts (1,905,857 cells/µL) compared to Group B (7730 cells/µL) (p=0.01).
- Group A also had higher mean RBC counts per high-power field (HPF) (68.9) than Group B (3.2) (p<0.01).
- Higher synovial fluid RBC counts correlated with the need for interventional angiography.
Conclusions:
- Synovial fluid analysis, particularly RBC count and RBC count per HPF, can predict conservative treatment outcomes in knee hemarthrosis.
- A synovial RBC count >81,500 cells/µL or >16.3 RBCs/HPF suggests potential failure of conservative treatment.
- Recommend immediate interventional angiography for patients with high synovial RBC counts to avoid prolonged conservative management.
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