Magnetic Resonance Angiography in the Management of Recurrent Hemarthrosis After Total Knee Arthroplasty

Thomas W. Hash, Alex B. Maderazo, Steven B. Haas, Gregory R. Saboeiro, David W. Trost, Hollis G. Potter

Research output: Contribution to journalArticlepeer-review

22 Scopus citations

Abstract

Spontaneous hemarthrosis is an infrequent but disabling complication after total knee arthroplasty. The purpose of this case series is to demonstrate the utility of magnetic resonance angiography (MRA) in the evaluation of hemarthrosis after total knee arthroplasty. Patients presenting with hemarthrosis unexplained by trauma, anticoagulation, or a bleeding diathesis were retrospectively identified. Eighteen patients were referred for MRA to evaluate recurrent hemarthrosis after failing conservative therapy (n = 16) or synovectomy (n = 2). Despite artifact caused by the metallic components, diagnostic evaluation of regional vessels was made. In 12 of 13 cases that underwent embolization or synovectomy, a hypertrophic feeding artery (or arteries) was visualized on MRA. One case of negative MRA did not have subsequent surgery, and we are unable to comment on the rate of false-positives because all patients in this case series had evidence of bleeding. By characterizing the vascular anatomy and identifying a dominant artery (or arteries) supplying the hypervascular synovium, MRA can serve as a guide for subsequent embolization or synovectomy, as indicated.

Original languageEnglish
Pages (from-to)1357-1361.e1
JournalJournal of Arthroplasty
Volume26
Issue number8
DOIs
StatePublished - Dec 2011
Externally publishedYes

Keywords

  • Embolization
  • Hemarthrosis
  • MRA
  • TKA

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