title: Embolization of spontaneous hemarthrosis post total knee replacement.
abstract: Spontaneous nonhemophiliac hemarthrosis is an unusual entity, which has been little described. We present three cases of spontaneous recurrent hemarthrosis post total knee replacement (TKR) and successful management with embolization. Three male patients were referred to our service for angiography and treatment of recurrent hemarthrosis post TKR. In all three patients antegrade ipsilateral common femoral artery punctures and selective angiography of the geniculate branches were performed with a microcatheter. Abnormal vasculature was noted in all cases. Subsequent embolization was performed with Contour (Boston Scientific, Target Vascular, Cork, Ireland) embolization particles (150-250 and 250-355 microm) in two patients and microcoils in the third (TornadoR; Cook Inc., Bloomington, IN, USA). Technical success was 100%. One patient had a recurrence of symptoms requiring a repeat procedure 6 months later. No complications were encountered. Selective angiography and particle embolization is an effective technique for management of this unusual but problematic postoperative sequelae.
authors.affiliation: Department of Radiology, The Alfred Hospital, Commercial Road, Prahran, Victoria, 3181, Australia. givenmark@hotmail.com
authors.forename: M F
authors.initials: MF
authors.lastname: Given
authors.forename: P
authors.initials: P
authors.lastname: Smith
authors.forename: S M
authors.initials: SM
authors.lastname: Lyon
authors.forename: D
authors.initials: D
authors.lastname: Robertson
authors.forename: K R
authors.initials: KR
authors.lastname: Thomson
mesh_terms: D000368:Aged; D000792:Angiography / Q000379:methods; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects* / Q000379:methods; D004621:Embolization, Therapeutic / Q000379:methods*; D006395:Hemarthrosis / Q000000981:diagnostic imaging* / Q000209:etiology / Q000628:therapy*; D006801:Humans; D007720:Knee Prosthesis / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D016059:Range of Motion, Articular / Q000502:physiology; D020127:Recovery of Function; D018570:Risk Assessment; D012494:Sampling Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome