Kambara Shunichiro, Yoshiya Shinichi, Onishi Shintaro, Yasumizu Ryoji, Tachibana Toshiya
Department of Orthopaedic Surgery, JCHO Kobe Central Hospital, Hyogo, Japan.
Department of Orthopaedic Surgery, Nishinomiya Kaisei Hospital, Hyogo, Japan.
Case Rep Orthop. 2023 Jun 17;2023:8806299. doi: 10.1155/2023/8806299. eCollection 2023.
In this case report, we report a patient with complicated with persistent hemarthrosis following arthroscopic meniscal repair. . A 41-year-old male patient presented with persistent swelling of the knee 6 months after arthroscopic meniscal repair and partial meniscectomy performed for lateral discoid meniscal tear. The initial surgery was performed at another hospital. Four months after the surgery, swelling of the knee was noted when he resumed running. At his initial visit to our hospital, intra-articular blood accumulation was revealed via joint aspiration. A second arthroscopic examination performed 7 months after the initial procedure showed healing of the meniscal repair site and synovial proliferation. The suture materials identified during the arthroscopy were removed. Histological examination of the resected synovial tissue showed inflammatory cell infiltration and neovascularization. In addition, a multinucleated giant cell was identified in the superficial layer. After the second arthroscopic surgery, the hemarthrosis did not recur, and the patient was able to resume running without symptom one and a half years post-surgery.
Bleeding from the proliferated synovia at or near the periphery of the lateral meniscus was thought to be the cause of the hemarthrosis as a rare complication following arthroscopic meniscal repair.
在本病例报告中，我们报告了一名在关节镜下半月板修复术后并发持续性关节积血的患者。一名41岁男性患者因外侧盘状半月板撕裂接受关节镜下半月板修复和部分半月板切除术后6个月，出现膝关节持续肿胀。初次手术在另一家医院进行。术后4个月，当他恢复跑步时，发现膝关节肿胀。在他初次就诊于我院时，通过关节穿刺抽出关节内积血。初次手术后7个月进行的第二次关节镜检查显示半月板修复部位愈合，滑膜增生。关节镜检查时发现的缝合材料被取出。切除的滑膜组织的组织学检查显示有炎性细胞浸润和新生血管形成。此外，在表层发现了一个多核巨细胞。第二次关节镜手术后，关节积血未复发，患者术后一年半能够无症状地恢复跑步。
外侧半月板周边或附近增生的滑膜出血被认为是关节镜下半月板修复术后罕见并发症关节积血的原因。
