A case of selective arterial embolization for recurrent hemarthrosis after total knee arthroplasty

Takezawa, Yasunobu; Fujita, Shuichi; Yamagami, Takuji; Tanaka, Osamu; Kubo, Toshikazu

doi:10.1007/s00776-011-0192-6

Cited by 7 publications

(5 citation statements)

References 8 publications

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“…Recurrent haemarthrosis, considered to be recurrent after two consecutive episodes, was also reported as an indication for revision of an Oxford UKA by Zermatten et al, 25 but appears to be a rare complication of knee arthroplasty and is mostly reported as individual cases. 24 , 26 - 29 Recurrent haemarthrosis is more dangerous after a partial knee arthroplasty than after a TKA as normal articular cartilage has been retained. This can be damaged by bleeding, much as in the case of haemophiliac arthrosis.…”

Section: Discussionmentioning

confidence: 99%

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The results of Oxford unicompartmental knee arthroplasty in the United States

Emerson

Alnachoukati

Barrington

et al. 2016

The Bone & Joint Journal

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AimsApproved by the Food and Drug Administration in 2004, the Phase III Oxford Medial Partial Knee is used to treat anteromedial osteoarthritis (AMOA) in patients with an intact anterior cruciate ligament. This unicompartmental knee arthroplasty (UKA) is relatively new in the United States, and therefore long-term American results are lacking.Patients and MethodsThis is a single surgeon, retrospective study based on prospectively collected data, analysing a consecutive series of primary UKAs using the Phase III mobile-bearing Oxford Knee and Phase III instrumentation.Between July 2004 and December 2006, the senior author (RHE) carried out a medial UKA in 173 patients (213 knees) for anteromedial osteoarthritis or avascular necrosis (AVN). A total of 95 patients were men and 78 were women. Their mean age at surgery was 67 years (38 to 89) and mean body mass index 29.87 kg/m2 (17 to 62).The mean follow-up was ten years (4 to 11).ResultsSurvivorship of the Oxford UKA at ten years was 88%, using life table analysis. Implant survivorship at ten years was 95%. The most common cause for revision was the progression of osteoarthritis in the lateral compartment. The mean knee score element of the American Knee Society Score (AKSS) was 50 pre-operatively and increased to 93 post-operatively. The mean AKSS function score was 56 pre-operatively rising to 78 post-operativelyConclusionThis ten-year follow-up study of the Oxford UKA undertaken in the United States shows good survivorship and excellent function in a wide selection of patients with AMOA and AVN.Cite this article: Bone Joint J 2016;98-B(10 Suppl B):34–40.

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Section: Discussionmentioning

confidence: 99%

“… 30 Structural joint damage can occur after just a few haemarthroses. 30 There are a number of ways to treat this including open synovectomy, 26 radiosynovectomy, 24 interventional embolisation, 28 , 29 and diagnostic arthroscopy. 31 …”

Section: Discussionmentioning

confidence: 99%

The results of Oxford unicompartmental knee arthroplasty in the United States

Emerson

Alnachoukati

Barrington

et al. 2016

The Bone & Joint Journal

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“…Sizes of particles chosen were 150-250 or 250-350 μm for PA and 500-700 μm for TAGM. Genicular arterial branches and/or the supra-articular popliteal artery were target arteries selectively embolized (4,(7)(8)(9)(10)(11)(12)(13)(14). In all cases reported, embolization was technically successful, with no clinical recurrence except for one.…”

Section: Discussionmentioning

confidence: 94%

“…In addition to surgical methods, case reports in which knee hemarthrosis was successfully treated by transarterial embolization, which is less invasive, have been published as listed in Table 2 (4,(7)(8)(9)(10)(11)(12)(13)(14). All but one of these reports describe treatment for recurrent hemarthrosis after total knee arthroplasty.…”

Section: Discussionmentioning

confidence: 99%

Selective arterial embolization with gelatin particles for refractory knee hemarthrosis

Yamagami

Yoshimatsu²,

Miura³

et al. 2013

Diagn Interv Radiol

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“…The most frequent reported causes of recurrent bleeding into the knee are entrapped proliferative synovial tissue or the fat pad caught between prosthetic components [9]. Other reported causes include tumors [3], retained meniscal fragments [7], pigmented villonodular synovitis [2], vascular causes (aneurysms, pseudoaneurysms, arteriovenous fistulae) [5,6,14,15,18], hematologic conditions [11], use of anticoagulants, or mechanical factors causing repetitive minor trauma such as malalignment, instability, and malposition of the implants [16]. In more than 50% of cases, no cause for bleeding is found [9].…”

Section: Discussionmentioning

confidence: 99%

Recurrent Hemarthroses After TKA Treated With an Intraarticular Injection of Yttrium-90

Fine

Klestov

2016

Clinical Orthopaedics &Amp; Related Research

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Background Recurrent hemarthroses after a TKA are uncommon and usually respond to nonoperative treatment or intervention using angiographic embolization or synovectomy. However, in rare circumstances, the problem can be resistant to treatment. Case Description We report the case of a patient who had recurrent hemarthroses after a TKA. During the first 18 months after surgery, the patient experienced 48 episodes consistent with bleeding into the knee. The bleeding episodes recurred despite use of traditional treatments, including arthroscopy, open synovectomy and embolization of a small, false aneurysm. The patient ultimately received an intraarticular injection of yttrium-90 silica/citrate, and the hemarthroses ceased soon after the injection. At last review, 25 months after the injection, the patient had experienced no additional bleeding episodes. Literature Review On review of the literature, we found only one other report in which yttrium-90 was used successfully in a similar situation. Clinical Relevance Yttrium-90 may be considered a treatment option in patients with recurrent hemarthroses after TKA, especially when the condition has not responded to more traditional treatments. The long-term risk of treatment with yttrium-90 for recurrent hemarthroses after a TKA remains unclear.

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A case of selective arterial embolization for recurrent hemarthrosis after total knee arthroplasty

Cited by 7 publications

References 8 publications

The results of Oxford unicompartmental knee arthroplasty in the United States

The results of Oxford unicompartmental knee arthroplasty in the United States

Selective arterial embolization with gelatin particles for refractory knee hemarthrosis

Recurrent Hemarthroses After TKA Treated With an Intraarticular Injection of Yttrium-90

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