Late recurrent hemarthrosis following elective total knee arthroplasty

Abstract

In certain scenarios following total knee arthroplasty (TKA), vascular complications can present as recurrent hemarthrosis, resulting in continued pain and restricted range of motion post-operatively. We present a 77 year old female who underwent a right TKA. She had an uncomplicated recovery for 1 year following the TKA, but then developed episodic knee pain, with pain and swelling, which resulted in limitations to ambulation. Work-up was negative for infection or hardware related complications. At presentation to our office 2 years following the right TKA, aspiration showed thick hemarthrosis from the right knee. Right lower extremity angiogram demonstrated a non-tumoral blush indicative of chronic synovial hyperemia. Patient underwent successful transarterial coil and selective embolization of the responsible geniculate arteries, resulting in complete resolution of symptoms at 2 years follow-up. Physicians and surgeons should be aware of vascular complications following TKA that can occur at mid or long term follow-up which may require therapeutic embolization for resolution of symptoms. Keywords: Hemarthrosis, Total knee arthroplasty, Embolization, Geniculate arteries.