Geniculate Artery Embolization in Patients With Recurrent Hemarthrosis After Knee Arthroplasty: A Retrospective Study.

Autor: Luyckx EGR; Department of Radiology, Antwerp University Hospital, Edegem, Belgium; Department of Medical Imaging and Interventional Radiology, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium., Mondelaers AMP; Department of Radiology, Antwerp University Hospital, Edegem, Belgium; Department of Medical Imaging and Interventional Radiology, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium., van der Zijden T; Department of Radiology, Antwerp University Hospital, Edegem, Belgium., Voormolen MHJ; Department of Radiology, Antwerp University Hospital, Edegem, Belgium; Department of Medical Imaging and Interventional Radiology, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium., Van den Bergh FRA; Department of Radiology, Antwerp University Hospital, Edegem, Belgium., d'Archambeau OC; Department of Radiology, Antwerp University Hospital, Edegem, Belgium.
Jazyk: angličtina
Zdroj: The Journal of arthroplasty [J Arthroplasty] 2020 Feb; Vol. 35 (2), pp. 550-556. Date of Electronic Publication: 2019 Sep 16.
DOI: 10.1016/j.arth.2019.09.014
Abstrakt: Background: Recurrent hemarthrosis after knee arthroplasty is an uncommon and disabling complication of this frequently performed procedure. Selective endovascular embolization of the geniculate arteries is one of the therapeutic options to manage this complication. The purpose of this study is to analyze the effectiveness of this treatment in patients suffering from recurrent hemarthrosis after knee arthroplasty.
Methods: We performed a retrospective study of 31 patients (39 embolization procedures) with recurrent hemarthrosis after knee arthroplasty. There were 17 men and 14 women with a median age of 67 years (range 48-90). All patients were referred for geniculate artery embolization between January 2007 and November 2016.
Results: Twenty-seven procedures were executed on the right side and 12 on the left side. Total knee arthroplasty was performed on 29 patients, only 2 patients underwent unicompartmental knee arthroplasty. Embolization of the superior geniculate arteries was achieved in all patients. In 12 of 39 procedures (31%), at least 1 of the inferior geniculate arteries could not be catheterized, therefore embolization was achieved through collaterals. Symptomatic improvement was observed in 26 of 31 patients (84%). Discomfort or mild postprocedural pain was observed in most patients, needing only minor pain medication, mostly resolving within 24 hours. Two patients presented with a severe complication: a 48-year-old male patient developed septic arthritis and an 85-year-old hypertensive female patient treated with anticoagulants showed aseptic necrosis of the femoral condyles.
Conclusion: Embolization of geniculate arteries is a safe and effective treatment in recurrent hemarthrosis post knee arthroplasty. Clinical improvement was seen in most patients.
(Copyright © 2019 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
Externí odkaz: