Haemarthroses after total knee arthroplasty caused by an isolated platelet factor 3 availability defect.
We present seven patients with recurrent haemarthroses after total knee arthroplasty, caused by an inherent platelet function defect. These patients developed painful knee swelling, persistent bleeding and/or wound breakdown, a platelet factor 3 availability defect being identified in all cases. Surgical exploration, with joint debridement, lavage and synovectomy, was performed in four patients who did not improve with conservative therapy. Histopathological examination of synovium revealed a focal synovial reaction with histiocytic infiltration, and occasional foreign-body giant cells. One patient required an early revision because of aseptic loosening of their tibial component. The condition was treated by single-donor platelet transfusions with good results. The diagnosis, management, and relevance of this disorder are discussed.
Malhotra
R
R
Department of Orthopaedics, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India. rmalhotra62@hotmail.com
Bhan
S
S
Kiran
E Krishna
EK
D000368:Aged; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects*; D001792:Blood Platelets / Q000502:physiology; D005260:Female; D006395:Hemarthrosis / Q000097:blood / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010977:Platelet Factor 3 / Q000502:physiology*; D011475:Prosthesis Failure; D012008:Recurrence; D012086:Reoperation
D010977:Platelet Factor 3