BACKGROUND Recurrent hemarthrosis is a rare complication of total knee arthroplasty,and only a few cases have been reported;hence,it is hard to establish comprehensive diagnosis and treatment guidelines.We here report...BACKGROUND Recurrent hemarthrosis is a rare complication of total knee arthroplasty,and only a few cases have been reported;hence,it is hard to establish comprehensive diagnosis and treatment guidelines.We here report a case of recurrent hemarthrosis after total knee arthroplasty,and briefly review the literature.CASE SUMMARY A 50-year-old man,with a history of hypertension,presented to the Orthopedic Department of our hospital for non-traumatic acute left knee pain and swelling associated with a warmth sensation 14 mo after total knee arthroplasty.Investigations(ultrasound,aspiration,and arthroscopy)and managements(nonsurgical,arthroscopy and open exploration)were performed,and the clinical effects of these interventions were analyzed separately.Clinical evidence indicates that the cause of this case was rupture of a pseudoaneurysm of the medial superior genicular artery.CONCLUSION The present case indicated that angiography is essential in cases of hemarthrosis after TKA;arthroscopy may not always be adequate as it may not provide a clear view;and traditional open exploration is still effective and sometimes necessary.展开更多
Background: Hemophilic arthropathy is a debilitating morbidity of hemophilia caused by recurrent joint bleeds. We investigated if the joint bleed volume, before initiation of treatment, was linked to the subsequent de...Background: Hemophilic arthropathy is a debilitating morbidity of hemophilia caused by recurrent joint bleeds. We investigated if the joint bleed volume, before initiation of treatment, was linked to the subsequent degree of histopathological changes and the development of bone pathology in a mouse model of hemophilic arthropathy.Methods: FVIII knock-out(F8-KO) mice were dosed with a micro-CT blood pool agent prior to induction of hemarthrosis. Eight hours after induction, the bleed volume was quantified with micro computed tomography(micro-CT) and recombinant FVIII treatment initiated. On Day 8, inflammation in the knees was characterized by fluorescence molecular tomography. On Day 14, knee pathology was characterized by micro-CT and histopathology. In a second study, contrast agent was injected into the knee of wild-type(WT) mice, followed by histopathological evaluation on Day 14.Results: The average joint bleed volume before treatment was 3.9 mm3. The inflammation-related fluorescent intensities in the injured knees were significantly increased on Day 8. The injured knees had significantly increased synovitis scores, vessel counts, and areas of hemosiderin compared to un-injured knees. However, no cartilage-or bone pathology was observed. The bleed volume before initiation of treatment correlated with the degree of synovitis and was associated with high fluorescent intensity on Day 8. In F8-KO and WT mice, persistence of contrast agent in the joint elicited morphological changes.Conclusion: When applying a delayed on-demand treatment regimen to hemophilic mice subjected to an induced knee hemarthrosis, the degree of histopathological changes on Day 14 reflected the bleed volume prior to initiation of treatment.展开更多
文摘BACKGROUND Recurrent hemarthrosis is a rare complication of total knee arthroplasty,and only a few cases have been reported;hence,it is hard to establish comprehensive diagnosis and treatment guidelines.We here report a case of recurrent hemarthrosis after total knee arthroplasty,and briefly review the literature.CASE SUMMARY A 50-year-old man,with a history of hypertension,presented to the Orthopedic Department of our hospital for non-traumatic acute left knee pain and swelling associated with a warmth sensation 14 mo after total knee arthroplasty.Investigations(ultrasound,aspiration,and arthroscopy)and managements(nonsurgical,arthroscopy and open exploration)were performed,and the clinical effects of these interventions were analyzed separately.Clinical evidence indicates that the cause of this case was rupture of a pseudoaneurysm of the medial superior genicular artery.CONCLUSION The present case indicated that angiography is essential in cases of hemarthrosis after TKA;arthroscopy may not always be adequate as it may not provide a clear view;and traditional open exploration is still effective and sometimes necessary.
文摘Background: Hemophilic arthropathy is a debilitating morbidity of hemophilia caused by recurrent joint bleeds. We investigated if the joint bleed volume, before initiation of treatment, was linked to the subsequent degree of histopathological changes and the development of bone pathology in a mouse model of hemophilic arthropathy.Methods: FVIII knock-out(F8-KO) mice were dosed with a micro-CT blood pool agent prior to induction of hemarthrosis. Eight hours after induction, the bleed volume was quantified with micro computed tomography(micro-CT) and recombinant FVIII treatment initiated. On Day 8, inflammation in the knees was characterized by fluorescence molecular tomography. On Day 14, knee pathology was characterized by micro-CT and histopathology. In a second study, contrast agent was injected into the knee of wild-type(WT) mice, followed by histopathological evaluation on Day 14.Results: The average joint bleed volume before treatment was 3.9 mm3. The inflammation-related fluorescent intensities in the injured knees were significantly increased on Day 8. The injured knees had significantly increased synovitis scores, vessel counts, and areas of hemosiderin compared to un-injured knees. However, no cartilage-or bone pathology was observed. The bleed volume before initiation of treatment correlated with the degree of synovitis and was associated with high fluorescent intensity on Day 8. In F8-KO and WT mice, persistence of contrast agent in the joint elicited morphological changes.Conclusion: When applying a delayed on-demand treatment regimen to hemophilic mice subjected to an induced knee hemarthrosis, the degree of histopathological changes on Day 14 reflected the bleed volume prior to initiation of treatment.
