Geniculate artery embolization for the treatment of refractory hemarthrosis following meniscal repair

Abstract

The present case report describes a unique example of recurrent hemarthrosis and associated arthralgia in a 41-year-old male after laparoscopic left medial meniscus repair, which failed to resolve with conservative treatment and surgical revision. Due to the worsening symptomatology as evidenced by increasing volume of aspirated blood during serial arthrocenteses and gradually decreasing range of motion of the joint despite surgical revision, geniculate artery embolization (GAE) was recommended. GAE is not routinely utilized to treat postoperative complications following meniscus repair; however, in the present case, utilizing selective angiographic embolization of the geniculate arteries led to successful treatment of recurrent spontaneous hemarthrosis and associated arthralgia. At this point, the patient has been symptom free for nine months. Relevant patient history, along with progress monitoring data from follow-up visits, demonstrates that spontaneous hemarthrosis and associated arthralgia following laparoscopic medial meniscus repair may be successfully treated with GAE. This is a noteworthy finding which underlines the importance of investigating alternative therapies in treatment refractory cases. However, a thorough evaluation of the appropriateness of this intervention is of paramount importance and its potential benefits need to be determined on a case-by-case basis.