Open Access, Peer-reviewed
pISSN 1226-2102
eISSN 2005-8918
    J Korean Orthop Assoc. 2014 Dec;49(6):480-484. Korean.
    Published online Dec 30, 2014.
    https://doi.org/10.4055/jkoa.2014.49.6.480
    Copyright © 2014 by The Korean Orthopaedic Association
    Case Report

    Therapeutic Embolization for Spontaneous Recurrent Hemarthrosis of the Knee in the Elderly

    Kwang-Won Lee, M.D., Youngdong Song, M.D.,* Dae Geon Song, M.D. and Won Sik Choy, M.D.
      • Department of Orthopedic Surgery, Eulji University Hospital, Daejeon, Korea.
      • *Department of Physical Examination, Korea Military Administration, Daejeon, Korea.
    • Correspondence to: Youngdong Song, M.D. Department of Physical Examination, Korea Military Administration, 189 Cheongsa-ro, Seo-gu, Daejeon 302-701, Korea. TEL: +82-42-481-2938, FAX: +82-42-481-2949, Email: osdryd@gmail.com
    Received January 02, 2014; Revised April 23, 2014; Accepted April 24, 2014.

    This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

    Abstract

    Without traumatic history, spontaneous hemarthrosis of the knee is a relatively rare condition, and there is no report of the diagnosis and treatments in Korea. In this case, magnetic resonance imaging and arthroscopic findings showed hemarthrosis and a lateral meniscus tear. Hemarthrosis of the patient remained after meniscus resection and coagulation; we then, found rupture of the lateral geniculate artery by computed tomography-angiography. We report on a case of successful treatment of spontaneous hemarthrosis with therapeutic embolization with a thorough review of the relevant literatures.

    Keywords
    hemarthrosis; therapeutic embolization; lateral menisci

    Figures

    Figure 1
    Plain radiograph showed asymmetric joint space narrowing (lateral side) of the left knee.

    Figure 2
    Magnetic resonance imaging showed hemarthrosis with increased suprapatellar fluid collection and air-fluid level and showed a bucket-handle type tear of the lateral meniscus with empty space in the lateral femorotibial joint space. (A) Sagittal plane. (B) Coronal plane.

    Figure 3
    (A) On arthroscopic finding, there was degenerative change in the lateral compartment and a bucket-handle tear was observed on the lateral meniscus and no abnormal finding of synovium. (B) Partial meniscectomy and coagulation was performed.

    Figure 4
    CT angiography showed contrast leakage on posterior and hemarthrosis of the left knee.

    Figure 5
    (A) Active bleeding and hypervascularity (arrow) were seen in intervention radiography. (B) After embolization, there was a significant reduction (arrow) in abnormal vascularity.

    References

      1. Wilson JN. Spontaneous haemarthrosis in osteoarthritis of knee; a report of five cases. Br Med J 1959;1:1327–1328.
      1. Kawamura H, Ogata K, Miura H, Arizono T, Sugioka Y. Spontaneous hemarthrosis of the knee in the elderly: etiology and treatment. Arthroscopy 1994;10:171–175.
      1. Sasho T, Ogino S, Tsuruoka H, et al. Spontaneous recurrent hemarthrosis of the knee in the elderly: arthroscopic treatment and etiology. Arthroscopy 2008;24:1027–1033.
      1. Arnoczky SP, Warren RF. Microvasculature of the human meniscus. Am J Sports Med 1982;10:90–95.
      1. Shim SS, Leung G. Blood supply of the knee joint. A microangiographic study in children and adults. Clin Orthop Relat Res 1986;208:119–125.
      1. Waldenberger P, Chemelli A, Hennerbichler A, et al. Transarterial embolization for the management of hemarthrosis of the knee. Eur J Radiol 2012;81:2737–2740.
      1. Son KM, Kim JK, Seo YI, Kim HA. A case of bilateral hemarthrosis due to pseudoaneurysms in a patient on anticoagulation therapy. J Clin Rheumatol 2013;19:206–208.
      1. Given MF, Smith P, Lyon SM, Robertson D, Thomson KR. Embolization of spontaneous hemarthrosis post total knee replacement. Cardiovasc Intervent Radiol 2008;31:986–988.
      1. Bagla S, Rholl KS, van Breda A, Sterling KM, van Breda A. Geniculate artery embolization in the management of spontaneous recurrent hemarthrosis of the knee: case series. J Vasc Interv Radiol 2013;24:439–442.
    Cited by
    Crossref 1
    Google Scholar 
    MeSH Terms
    Aged*
    Arteries
    Diagnosis
    Embolization, Therapeutic*
    Hemarthrosis*
    Humans
    Knee*
    Korea
    Magnetic Resonance Imaging
    Menisci, Tibial
    Rupture
    Metrics
    Share
    Figures
    slide
    slide
    slide
    slide
    slide

    1 / 5

    PERMALINK