Rutgers New Jersey Medical School, Newark, NJ, USA.
Hospital for Special Surgery, New York, NY, USA.
Cartilage. 2021 Dec;13(1_suppl):116S-121S. doi: 10.1177/1947603520942937. Epub 2020 Jul 22.
The knee joint is one of the most frequently injured joints in the body, and the resulting injury may often lead to the presence of a bloody effusion, or hemarthrosis. The acute management of this condition can have long-lasting implications, and may ultimately result in the early onset of osteoarthritis in this population. Heme, a breakdown product of erythrocytes, and associated pro-inflammatory mediators, are known to have deleterious interactions with cartilage and synovium. The presence of blood in a joint following injury can precipitate these effects and accelerate the degenerative changes in the joint. Currently, there is no consensus on the optimal management of a traumatic knee joint injury with a hemarthrosis. Nontraumatic hemarthosis, seen most commonly in hemophilia patients, has a set of established guidelines that does not routinely recommend drainage of the joint. This article presents a rationale for joint aspiration to minimize the harmful effects of blood following traumatic hemarthrosis.
膝关节是人体最常受伤的关节之一,受伤后常常会导致关节内积血,即血 肿。这种情况的急性处理会产生长期影响,最终可能导致该人群中骨关节炎的早发。众所周知,红细胞的降解产物——血红素及其相关促炎介质与软骨和滑膜有有害的相互作用。受伤后关节内出血会引发这些影响,并加速关节的退行性变化。目前,对于创伤性膝关节损伤伴血 肿,尚无关于最佳处理方法的共识。非创伤性血 肿最常见于血友病患者,有一套既定的指南,不常规建议引流关节。本文提出了关节抽吸的基本原理,以最大限度地减少创伤性血 肿后血液的有害影响。