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Angiographic findings and therapeutic embolization of late hemarthrosis after total joint arthroplasty

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Abstract

Objective

The objective of this study was to describe the angiographic findings of late spontaneous hemarthrosis after total joint arthroplasty and to illustrate the therapeutic role of angiography.

Materials and methods

A retrospective multicenter study was performed looking for patients who underwent an angiography for spontaneous hemarthrosis occurring at least 1 month after total joint arthroplasty. Eight patients were included, all suffering from spontaneous hemarthrosis. One patient had an additional large extra-articular hematoma.

Results

Angiography in eight cases revealed hypertrophic vascular synovium in seven patients with an additional false aneurysm in one patient. Hypervascularization with pooling of contrast spots was seen in one patient. Five patients underwent selective arterial particulate embolization. Three patients were successfully embolized after one session, one was successful after two sessions, and one patient needed surgery after two embolization sessions.

Conclusion

Angiography for late spontaneous hemarthrosis is very effective to exclude or establish vascular malformations and to establish the diagnosis of hypertrophic vascular synovium. Selective arterial embolization seems to be a good therapeutic option as alternative to open or arthroscopic synovectomy.

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Authors and Affiliations

  1. Department of Vascular and Interventional Radiology, Ghent University Hospital, De Pintelaan 185, 9000, Ghent, Belgium

    E. Dhondt & L. Defreyne

  2. Department of Radiology, General Hospital St-Maarten, Duffel-Mechelen, Belgium

    F. M. Vanhoenacker & A. Snoeckx

  3. Department of Radiology, University Hospital Antwerp, Antwerp, Belgium

    F. M. Vanhoenacker, O. d’ Archambeau & A. Snoeckx

Authors
  1. E. Dhondt
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  2. F. M. Vanhoenacker
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  3. O. d’ Archambeau
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  4. A. Snoeckx
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  5. L. Defreyne
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Corresponding author

Correspondence to E. Dhondt.

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Dhondt, E., Vanhoenacker, F.M., d’ Archambeau, O. et al. Angiographic findings and therapeutic embolization of late hemarthrosis after total joint arthroplasty. Skeletal Radiol 38, 31–36 (2009). https://doi.org/10.1007/s00256-008-0569-6

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  • DOI: https://doi.org/10.1007/s00256-008-0569-6

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