Li Y, Tian H, Zhang K
Department of Orthopedics, Peking University Third Hospital, Beijing 100191, China.
Zhonghua Wai Ke Za Zhi. 2016 Dec 1;54(12):955-959. doi: 10.3760/cma.j.issn.0529-5815.2016.12.018.
Recurrent hemarthrosis is a relatively rare complication after total knee arthroplasty with the incidence estimated between 0.3% and 1.6%. There are various causes of this complication which can be broadly divided into general and local reasons. If the blood coagulation function was normal, the most common reason of hemarthrosis is the impingement of proliferative synovium between the articulating components of the knee prosthesis. However, some causes are not well understood which make diagnosis and treatment more difficult. Conservative therapy is the preferred treatment including rest, cooling, aspiration, and elevation. If conservative treatment is not successful, as next step an angiography and angiographic embolization of the source of bleeding is indicated. If embolization is unsuccessful, open synovectomy or arthroscopic is the next step. If these approaches are unsuccessful, the previously mentioned steps should be repeated until the cause of recurrent hemarthrosis become clear and the bleeding have been stopped.
复发性关节积血是全膝关节置换术后一种相对罕见的并发症，发生率估计在0.3%至1.6%之间。该并发症有多种原因，大致可分为全身和局部因素。如果凝血功能正常，关节积血最常见的原因是膝关节假体关节部件之间增生滑膜的撞击。然而，有些原因尚不清楚，这使得诊断和治疗更加困难。保守治疗是首选治疗方法，包括休息、冷敷、穿刺抽吸和抬高患肢。如果保守治疗不成功，下一步应进行血管造影及对出血源进行血管造影栓塞。如果栓塞不成功，下一步是开放性滑膜切除术或关节镜手术。如果这些方法都不成功，应重复上述步骤，直到复发性关节积血的原因明确且出血停止。
