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Recurrent hemarthrosis after total knee arthroplasty

R L Worland1, D E Jessup

  • 1Advanced Orthopaedic Centers, Health South Medical Center, Richmond, VA 23294, USA.

The Journal of Arthroplasty
|December 1, 1996
PubMed
Summary

Recurrent hemarthroses after total knee arthroplasty can be effectively treated with open synovectomy. This procedure resolves bleeding and improves patient outcomes, addressing synovitis linked to component entrapment.

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Area of Science:

  • Orthopedic Surgery
  • Rheumatology
  • Biomedical Engineering

Background:

  • Recurrent hemarthrosis is a rare but significant complication following total knee arthroplasty (TKA).
  • The etiology of these bleeds is often unclear, impacting patient quality of life and joint function.

Purpose of the Study:

  • To investigate the clinical presentation, treatment, and outcomes of patients experiencing recurrent hemarthrosis post-TKA.
  • To explore the underlying pathological mechanisms contributing to these bleeding events.

Main Methods:

  • A retrospective case series of seven patients who developed recurrent hemarthroses after TKA.
  • Analysis of time intervals between arthroplasty, first bleed, and synovectomy.
  • Histological examination of synovium removed during open synovectomy.

Main Results:

  • Seven patients presented with recurrent hemarthrosis, averaging over 20 months post-TKA.
  • All patients underwent open synovectomy, with an average interval of 21 months post-arthroplasty.
  • Histology revealed chronic synovitis with fibrosis and hemosiderin staining, suggesting proliferative synovial tissue entrapment.

Conclusions:

  • Open synovectomy is an effective treatment for recurrent hemarthrosis following TKA.
  • Entrapment of proliferative synovium between prosthetic components is a likely cause of these bleeds.
  • The procedure yielded excellent results, with no further bleeds reported during long-term follow-up.

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