Geniculate Artery Embolization in Patients With Recurrent Hemarthrosis After Knee Arthroplasty: A Retrospective Study |
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| Institution: | 1. Department of Radiology, Antwerp University Hospital, Edegem, Belgium;2. Department of Medical Imaging and Interventional Radiology, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium;1. Department of Orthopaedic Surgery, The Permanente Medical Group, San Leandro, CA;2. Surgical Outcomes and Analysis, Kaiser Permanente, San Diego, CA;3. Department of Spine Surgery, The Permanente Medical Group, Oakland, CA;4. Department of Orthopaedic Surgery, Southern California Permanente Medical Group, Los Angeles, CA;5. Department of Neurosurgery, The Permanente Medical Group, Sacramento, CA;1. Rothman Orthopaedic Institute, Philadelphia, PA;2. Department of Orthopaedic Surgery, Iran University of Medical Sciences, Tehran, Iran;1. Department of Orthopaedic Medical Engineering, Osaka University Graduate School of Medicine, Suita, Osaka, Japan;2. Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Suita, Osaka, Japan;3. Arthroplasty center, Kyowakai Hospital, Suita, Osaka, Japan;4. Department of Orthopaedic Surgery, Japan Community Health Care Organization Hoshigaoka Medical Center, Hirakata, Osaka, Japan;1. Department of Orthopaedic Surgery, Kobe Kaisei Hospital, Nada, Kobe, Japan;2. Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Chuo, Kobe, Japan |
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| Abstract: | BackgroundRecurrent hemarthrosis after knee arthroplasty is an uncommon and disabling complication of this frequently performed procedure. Selective endovascular embolization of the geniculate arteries is one of the therapeutic options to manage this complication. The purpose of this study is to analyze the effectiveness of this treatment in patients suffering from recurrent hemarthrosis after knee arthroplasty.MethodsWe performed a retrospective study of 31 patients (39 embolization procedures) with recurrent hemarthrosis after knee arthroplasty. There were 17 men and 14 women with a median age of 67 years (range 48-90). All patients were referred for geniculate artery embolization between January 2007 and November 2016.ResultsTwenty-seven procedures were executed on the right side and 12 on the left side. Total knee arthroplasty was performed on 29 patients, only 2 patients underwent unicompartmental knee arthroplasty. Embolization of the superior geniculate arteries was achieved in all patients. In 12 of 39 procedures (31%), at least 1 of the inferior geniculate arteries could not be catheterized, therefore embolization was achieved through collaterals. Symptomatic improvement was observed in 26 of 31 patients (84%). Discomfort or mild postprocedural pain was observed in most patients, needing only minor pain medication, mostly resolving within 24 hours. Two patients presented with a severe complication: a 48-year-old male patient developed septic arthritis and an 85-year-old hypertensive female patient treated with anticoagulants showed aseptic necrosis of the femoral condyles.ConclusionEmbolization of geniculate arteries is a safe and effective treatment in recurrent hemarthrosis post knee arthroplasty. Clinical improvement was seen in most patients. |
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| Keywords: | total knee arthroplasty unicompartmental knee arthroplasty hemarthrosis embolization geniculate arteries |
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