Angiographic findings and therapeutic embolization of late hemarthrosis after total joint arthroplasty.
OBJECTIVE
The objective of this study was to describe the angiographic findings of late spontaneous hemarthrosis after total joint arthroplasty and to illustrate the therapeutic role of angiography.


METHODS
A retrospective multicenter study was performed looking for patients who underwent an angiography for spontaneous hemarthrosis occurring at least 1 month after total joint arthroplasty. Eight patients were included, all suffering from spontaneous hemarthrosis. One patient had an additional large extra-articular hematoma.


RESULTS
Angiography in eight cases revealed hypertrophic vascular synovium in seven patients with an additional false aneurysm in one patient. Hypervascularization with pooling of contrast spots was seen in one patient. Five patients underwent selective arterial particulate embolization. Three patients were successfully embolized after one session, one was successful after two sessions, and one patient needed surgery after two embolization sessions.


CONCLUSIONS
Angiography for late spontaneous hemarthrosis is very effective to exclude or establish vascular malformations and to establish the diagnosis of hypertrophic vascular synovium. Selective arterial embolization seems to be a good therapeutic option as alternative to open or arthroscopic synovectomy.
Dhondt
E
E
Department of Vascular and Interventional Radiology, Ghent University Hospital, De Pintelaan 185, 9000, Ghent, Belgium. elisabethdhondt@yahoo.com
Vanhoenacker
F M
FM
D' Archambeau
O
O
Snoeckx
A
A
Defreyne
L
L
D000368:Aged; D000369:Aged, 80 and over; D015901:Angiography, Digital Subtraction; D019643:Arthroplasty, Replacement; D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D006395:Hemarthrosis / Q000000981:diagnostic imaging* / Q000628:therapy*; D006801:Humans; D008297:Male; D011183:Postoperative Complications / Q000000981:diagnostic imaging* / Q000628:therapy*; D012189:Retrospective Studies
J Arthroplasty. 1995 Nov;10 Suppl:S52-5
8776056
Joint Bone Spine. 2003 Feb;70(1):58-60
12639619
J Bone Joint Surg Am. 1997 Apr;79(4):594-6
9111408
J Arthroplasty. 1996 Dec;11(8):977-8
8986579
J Bone Joint Surg Br. 1996 May;78(3):458-60
8636186
Knee. 2004 Oct;11(5):413-5
15351420
Cardiovasc Intervent Radiol. 2008 Sep-Oct;31(5):986-8
18185956
Lancet. 1997 Mar 15;349(9054):766-8
9074576
J Arthroplasty. 2001 Oct;16(7):935-7
11607913
J Bone Joint Surg Am. 1991 Sep;73(8):1257-9
1890130
J Arthroplasty. 1995 Nov;10 Suppl:S56-8
8776057