Sirola Suvi-Maria, Heikkinen Juuso, Kerimaa Pekka, Kariniemi Juho, Niinimäki Tuukka
University of Oulu, Faculty of Medicine, Oulu; Oulu University Hospital, Department of Orthopedics and Traumatology, Oulu, Finland.
Oulu University Hospital, Department of Radiology, Oulu, Finland.
Acta Orthop. 2025 Jan 9;96:33-37. doi: 10.2340/17453674.2024.42660.
Recurrent hemarthrosis (RH) is a rare late complication of knee arthroplasty, with an unknown etiology. We aimed to evaluate the effectiveness of arterial embolization (AE) on resolution of hemarthrosis following knee arthroplasty. Additionally, we investigated pain management requirements after the procedure and related complications.
56 patients underwent AE for recurrent hemarthrosis between 2015 and 2023. The prevalence of hemarthrosis was 0.6%. The median age of the patients was 70 years (range 42-88), with 41 females and 15 males. 70 embolizations were performed, consisting of 56 initial procedures and 14 repeat procedures. Clinical success was defined as the resolution of hemarthroses.
Technical success was achieved in 93% of cases. Clinical success improved from 64% to 79% after the second treatment; subsequent sessions did not yield further improvement. 12 patients (21%) required 1 or more reoperations. The majority of patients (86%) relied solely on analgesics for post-treatment pain management. Complications occurred in 7% of treatments, most of which resolved spontaneously.
AE is effective in the treatment of recurrent hemarthrosis but 21% had reoccurance. Oral analgesics are generally sufficient for managing post-embolization pain. 7% had complications.
复发性关节积血（RH）是膝关节置换术后一种罕见的晚期并发症，病因不明。我们旨在评估动脉栓塞（AE）对膝关节置换术后关节积血消退的有效性。此外，我们还研究了该手术后的疼痛管理需求及相关并发症。
2015年至2023年间，56例患者因复发性关节积血接受了动脉栓塞治疗。关节积血的发生率为0.6%。患者的中位年龄为70岁（范围42 - 88岁），其中女性41例，男性15例。共进行了70次栓塞，包括56次初次手术和14次重复手术。临床成功定义为关节积血消退。
93%的病例取得了技术成功。第二次治疗后临床成功率从64%提高到79%；后续治疗未进一步改善。12例患者（21%）需要进行1次或多次再次手术。大多数患者（86%）仅依靠镇痛药进行治疗后疼痛管理。7%的治疗出现并发症，大多数并发症可自行缓解。
动脉栓塞对复发性关节积血有效，但21%的患者出现复发。口服镇痛药通常足以控制栓塞后疼痛。7%的患者出现并发症。
