Knee Surg Relat Res  
Treatment of Recurrent Hemarthrosis after Total Knee Arthroplasty
Ju-Hyung Yoo, MD, Hyun-Cheol Oh, MD, Sang-Hoon Park, MD, Sanghyeon Lee, MD, Yunjae Lee, MD, and Seong-Hun Kim, MD
Department of Orthopedic Surgery, National Health Insurance Service Ilsan Hospital, Goyang, Korea
Correspondence to: Seong-Hun Kim, MD
Department of Orthopedic Surgery, National Health Insurance Service Ilsan Hospital, 100 Ilsan-ro, Ilsandong-gu, Goyang 10444, Korea
Tel: +82-31-900-0436, Fax: +82-31-900-0343
E-mail: esmeron@naver.com
Received: July 29, 2017; Revised: November 3, 2017; Accepted: December 2, 2017; Published online: April 30, 2018.
© Korean Knee Society. All rights reserved.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Purpose: The purpose of this study is to evaluate the incidence and treatment of recurrent hemarthrosis after total knee replacement (TKR).
Materials and Methods: Among a total of 5,510 patients who underwent TKR from March 2000 to October 2016, patients who had two or more bleeding 2 weeks after surgery were studied. Conservative treatments were performed for all cases with symptoms. In patients who did not respond to conservative treatment several times, embolization was performed. We retrospectively evaluated the postoperative bleeding time, bleeding frequency, treatment method, and outcome.
Results: Seventeen (0.3%) of the 5,510 patients developed recurrent hemarthrosis. Bleeding occurred at an average of 2 years 3 months after the operation. Joint aspiration was performed 3.5 times (range, 2 to 10 times) on average, and 14 cases (82.3%) were treated with conservative treatment. In 3 patients with severe bleeding and hemorrhage, embolization was performed.
Conclusions: Recurrent hemarthrosis after TKR is a rare disease with a low incidence of 0.3% and usually could be treated by conservative treatment. If recurrences occur repeatedly, embolization through angiography or surgical treatment may be considered, but the results are not satisfactory and careful selection of treatment modalities is warranted.
Keywords: Knee, Arthroplasty, Hemarthrosis, Embolization


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