Recurrent Hemarthrosis Following Total Knee Arthroplasty

Held, M; Grosso, Matthew J.; Sarpong, Nana O.; Hamilton, William G.; Sista, Akhilesh K.; Macaulay, William

doi:10.2106/jbjs.rvw.19.00012

Cited by 2 publications

(3 citation statements)

References 41 publications

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“…[15][16][17][18][19] Of these 16 ROR cases, only 3 (0.1% of the total cohort) were due to hemarthrosis, much lower than that reported in the literature following TKA (0.3-1.6%). 20 In our series, weight-based TXA and closed suction drain use resulted in low observed risk for transfusion, hemarthrosis, and ROR, seemingly preserving the purported benefits of both IV TXA and closed suction drain usage without incurring complications previously linked to drain use. However, one of the patients in our case series did ROR due to a broken drain tube.…”

Section: Discussionmentioning

confidence: 57%

“…Sixteen patients had to return to the operating room within 90 days of primary TKA (0.8%), a rate substantially lower than prior database and national registry studies reporting a rate between 1-3.4% [15][16][17][18][19] . Of these 16 ROR cases, only 3 (0.1% of the total cohort) were due to hemarthrosis, much lower than that reported in the literature following TKA (0.3% to 1.6%) 20 . In our series, weight based TXA and closed suction drain use resulted in low observed risk for transfusion, hemarthrosis and ROR, seemingly preserving the purported benefits of both IV TXA and closed suction drain usage without incurring complications previously linked to drain use.…”

Section: Discussionmentioning

confidence: 60%

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Closed Suction Drainage after Total Knee Arthroplasty with Concomitant Intravenous Tranexamic Acid Administration

Case

Thomas

Edgington³

et al. 2023

J Knee Surg

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Introduction: Drain use in total knee arthroplasty (TKA) remains controversial. Use has been associated with increased complications, particularly post-operative transfusion, infection, increased cost, and longer hospital stays. However, studies examining drain use were performed before widespread adoption of tranexamic acid (TXA) which markedly reduces transfusion without increasing VTE events. We aim to investigate incidence of post-operative transfusion and 90-day return to the operating room (ROR) for hemarthrosis in TKA with use of drains and concomitant intravenous TXA. Methods: Primary TKAs from a single institution were identified from August 2012-December 2018. Inclusion criteria were primary TKA, age 18 years and over where use of TXA, drains, anticoagulant, and pre-and post-surgical Hb were documented during the patient’s admission. Primary outcomes were 90-day ROR specifically for hemarthrosis and rate of post-operative transfusion. Results: A total of 2008 patients were included. Sixteen patients required ROR, three of which were due to hemarthrosis. Drain output was statistically higher in the ROR group (269.3mL vs. 152.4mL (p = 0.05)). Five patients required transfusion within 14 days (0.25%). Patients requiring transfusion had significantly lower presurgical Hb (10.2g/dL, p=0.01) and 24-hr postoperative Hb (7.7g/dL, p< 0.001). Drain output between the transfusion and no transfusion groups varied significantly (p=0.03), with transfusion patients having higher POD 1 drain output of 362.6mL and total drain output of 376.6mL. Conclusion: In this series, post-operative drain use with concomitant weight-based IV TXA is shown to be safe and efficacious. We observed exceedingly low risk of post-operative transfusion compared to prior reports of drain use alone, as well as preserved low rate of hemarthrosis that has previously been positively linked to drain use.

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Section: Discussionmentioning

confidence: 57%

Section: Discussionmentioning

confidence: 60%

Closed Suction Drainage after Total Knee Arthroplasty with Concomitant Intravenous Tranexamic Acid Administration

Case

Thomas

Edgington³

et al. 2023

J Knee Surg

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“…Hemarthrosis should always be suspected trauma, after a traumatic effusion 3 . Plain radiographs, computed tomography scan, or magnetic resonance imaging can be useful for diagnosis in this setting 2,13 . Arthrocentesis is required for a definitive diagnosis 2 .…”

mentioning

confidence: 99%

Recurrent Hemarthrosis Secondary to Erosive Patellofemoral Arthritis Treated with Arthroplasty

Turner

Duke²,

Murray

et al. 2022

JBJS Case Connector

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Case:Three patients presented with recurrent hemarthrosis secondary to erosive patellofemoral arthritis. Recurrent hemarthrosis from the eroded patellofemoral subchondral bone has not been well described. Each patient presented with symptoms secondary to painful effusions that were identified by aspiration. Each patient was successfully treated with patellofemoral or total knee arthroplastyConclusion:Spontaneous or recurrent effusions in the setting of erosive patellofemoral arthritis should prompt orthopaedic surgeons to consider hemarthrosis as the cause of such effusions. Patellofemoral or total knee arthroplasty is effective in resolving the hemarthroses, resolving pain, and restoring function in these patients.

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Recurrent Hemarthrosis Following Total Knee Arthroplasty

Abstract: Recurrent hemarthrosis is a treatable complication following total knee arthroplasty that can cause debilitating symptoms that can affect outcomes following a total knee arthroplasty.

Cited by 2 publications

References 41 publications

Closed Suction Drainage after Total Knee Arthroplasty with Concomitant Intravenous Tranexamic Acid Administration

Closed Suction Drainage after Total Knee Arthroplasty with Concomitant Intravenous Tranexamic Acid Administration

Recurrent Hemarthrosis Secondary to Erosive Patellofemoral Arthritis Treated with Arthroplasty

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