Recurrent spontaneous hemarthrosis after total knee arthroplasty successfully treated with synoviorthesis.
A case of spontaneous recurrent hemarthrosis--due to developed hypertrophied synovium--after total knee arthroplasty is reported. The patient was successfully treated with radiosynovectomy. The first hemorrhage occurred 18 months after the total knee arthroplasty. Several similar episodes followed over a period of 4 years. Because conservative treatment failed to control the bleeding, an arthroscopic lavage was performed, which revealed the existence of proliferative synovium. A significant part of the hypertrophic tissue was excised with the use of a thermocoagulator. However, 1 month later, another episode of hemarthrosis occurred. As a final step before reoperation, the patient was treated with intra-articular injection of ytrium 90. Eighteen months later, she remains symptom-free, is very satisfied with the result, and reports no new episode of hemarthrosis.
Kapetanos
George A
GA
Third Orthopaedic Department, Aristotle University of Thessaloniki Medical School, Papageorgiou General Hospital, Thessaloniki, Greece.
Papavasiliou
Kyriakos A
KA
Makris
Vassilios
V
Nikolaides
Anastasios P
AP
Kirkos
John M
JM
Symeonides
Panayotis P
PP
D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects*; D005260:Female; D006395:Hemarthrosis / Q000175:diagnosis / Q000209:etiology* / Q000532:radiotherapy*; D006801:Humans; D006984:Hypertrophy; D008875:Middle Aged; D012008:Recurrence; D013583:Synovial Membrane / Q000473:pathology / Q000528:radiation effects*; D015021:Yttrium Radioisotopes
D015021:Yttrium Radioisotopes