Ko Sang-Hun, Jung Kwang-Hwan, Cha Jae-Ryong, Park Ki-Bong
Department of Orthopedic Surgery, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan 44033, Korea.
Diagnostics (Basel). 2022 Apr 13;12(4):976. doi: 10.3390/diagnostics12040976.
Studies regarding the variables that could predict the success of conservative treatment for knee hemarthrosis are lacking. This retrospective study evaluated the laboratory variables of patients who had unsatisfactory results from conservative treatment for knee hemarthrosis. Twenty-nine patients conservatively treated for knee hemarthrosis were included and divided into two groups: group A comprised 14 patients who underwent interventional angiography and selective embolization due to failed conservative treatment, and group B comprised 15 patients with successful results after conservative treatment. The results of the serological and synovial fluid tests were evaluated. The mean number of synovial red blood cells (RBCs) was 1,905,857 cells/µL and 7730 cells/µL in groups A and B, respectively (p = 0.01), while the mean number of RBCs per high-power field (HPF) was 68.9 and 3.2, respectively (p < 0.01). Patients who underwent interventional angiography and selective embolization after failed conservative treatment for knee hemarthrosis had higher synovial RBC counts and RBC counts per HPF than those with successful outcomes after conservative treatment. It is necessary to carefully interpret the results of the synovial fluid analysis in patients with knee hemarthrosis; if the synovial fluid analysis shows a synovial RBC count greater than 81,500 and RBC count per HPF greater than 16.3, we recommend immediate interventional angiography rather than continuing conservative treatment.
目前缺乏关于可预测膝关节血肿保守治疗成功与否的变量的研究。本回顾性研究评估了膝关节血肿保守治疗效果不佳的患者的实验室变量。纳入了29例接受膝关节血肿保守治疗的患者,并将其分为两组:A组包括14例因保守治疗失败而接受介入性血管造影和选择性栓塞的患者,B组包括15例保守治疗后取得成功的患者。评估了血清学和滑液检查结果。A组和B组滑液中红细胞(RBC)的平均数量分别为1,905,857个/微升和7730个/微升(p = 0.01),而每高倍视野(HPF)的RBC平均数量分别为68.9和3.2(p < 0.01)。膝关节血肿保守治疗失败后接受介入性血管造影和选择性栓塞的患者,其滑液RBC计数和每HPF的RBC计数高于保守治疗成功的患者。对于膝关节血肿患者,有必要仔细解读滑液分析结果;如果滑液分析显示滑液RBC计数大于81,500且每HPF的RBC计数大于16.3,我们建议立即进行介入性血管造影,而不是继续保守治疗。