Case Report
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. May 26, 2020; 8(10): 1966-1972
Published online May 26, 2020. doi: 10.12998/wjcc.v8.i10.1966
Traditional investigation and management for recurrent hemarthrosis after total knee arthroplasty: A case report
Xiao Geng, Yang Li, Xuan He, Hua Tian
Xiao Geng, Yang Li, Xuan He, Hua Tian, Orthopedic Department, Peking University Third Hospital, Beijing 100191, China
Author contributions: Geng X and Li Y contributed equally to the work, as co-first authors; Geng X, Li Y and He X reviewed the literature and contributed to manuscript drafting; Tian H revised the manuscript for important intellectual content; all authors issued final approval for the version to be submitted.
Informed consent statement: Informed written consent was obtained from the patient.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Hua Tian, MD, Professor, Orthopedic Department, Peking University Third Hospital, No. 49 North Garden Rd, Haidian District, Beijing 100191, China. tianhua@bjmu.edu.cn
Received: February 10, 2020
Peer-review started: February 10, 2020
First decision: April 1, 2020
Revised: April 8, 2020
Accepted: April 17, 2020
Article in press: April 17, 2020
Published online: May 26, 2020
Processing time: 104 Days and 20.9 Hours
Abstract
BACKGROUND

Recurrent hemarthrosis is a rare complication of total knee arthroplasty, and only a few cases have been reported; hence, it is hard to establish comprehensive diagnosis and treatment guidelines. We here report a case of recurrent hemarthrosis after total knee arthroplasty, and briefly review the literature.

CASE SUMMARY

A 50-year-old man, with a history of hypertension, presented to the Orthopedic Department of our hospital for non-traumatic acute left knee pain and swelling associated with a warmth sensation 14 mo after total knee arthroplasty. Investigations (ultrasound, aspiration, and arthroscopy) and managements (non-surgical, arthroscopy and open exploration) were performed, and the clinical effects of these interventions were analyzed separately. Clinical evidence indicates that the cause of this case was rupture of a pseudoaneurysm of the medial superior genicular artery.

CONCLUSION

The present case indicated that angiography is essential in cases of hemarthrosis after TKA; arthroscopy may not always be adequate as it may not provide a clear view; and traditional open exploration is still effective and sometimes necessary.

Keywords: Total knee arthroplasty; Recurrent hemarthrosis; Arthroscopy; Open exploration; Case report

Core tip: Recurrent hemarthrosis is a rare complication of total knee arthroplasty, and only a few cases have been reported; hence, it is hard to establish comprehensive diagnosis and treatment guidelines. We present herein a rare case of recurrent hemarthrosis which occurred 14 mo after total knee arthroplasty. The patient underwent traditional investigations (ultrasound, aspiration, and arthroscopy) and managements (non-surgical, arthroscopy and open exploration), and the clinical effects of these interventions were analyzed separately. Clinical evidence indicated that the cause of recurrent hemarthrosis in this case was rupture of a pseudoaneurysm of the medial superior genicular artery.