Kindsfater K, Scott R
Brigham & Women's Hospital and New England Baptist Hospital, Boston, Massachusetts, USA.
J Arthroplasty. 1995 Nov;10 Suppl:S52-5. doi: 10.1016/s0883-5403(05)80231-1.
Thirty patients who developed recurrent hemarthrosis after total knee arthroplasty were followed for an average of 27.9 months. The average interval between implantation of the prosthesis and the first bleed was 24.2 months. Nine knees responded to conservative care alone. The remaining 21 knees continued to have recurrent bleeds requiring surgical intervention. Open synovectomy was performed in 15 knees and seemed to be curative in 14 (93%). Forty-three percent of the surgically treated knees were noted to have entrapment of proliferative synovial tissue or the fat pad between prosthetic components as the cause of the recurrent bleeds. Consistent histologic findings included focal synovial hyperplasia and significant hemosiderin deposition. Although similar, these changes should not be confused with those of pigmented villonodular synovitis.
30例全膝关节置换术后出现复发性关节积血的患者接受了平均27.9个月的随访。假体植入与首次出血之间的平均间隔为24.2个月。9个膝关节仅对保守治疗有效。其余21个膝关节继续出现复发性出血，需要手术干预。15个膝关节进行了开放性滑膜切除术，其中14个（93%）似乎治愈。43%接受手术治疗的膝关节被发现增生的滑膜组织或脂肪垫被假体部件夹住是复发性出血的原因。一致的组织学表现包括局灶性滑膜增生和大量含铁血黄素沉积。虽然相似，但这些变化不应与色素沉着绒毛结节性滑膜炎的变化相混淆。
