Embolization of Genicular Arteries for Chronic Hemarthrosis Post Knee Prosthesis

 

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Background: Post-operative hemarthrosis after knee prosthesis can be invalidating due to painful swelling of the knee and diminished mobility. We describe the technique and clinical results of endovascular embolisation of genicular arteries. Methods: From 01.2007 until 12.2016, 31 patients were treated (17 m, 14 w) with a mean age of 67 y (range 48-90). A total of 38 embolisation procedures were performed (31-1, 5-2 and 1-3), 26 right and 12 left sided. The mean time from surgery to symptoms was 24, 4 months (range 1-64) and embolisation was 27,4 months (range 1-70). Surgery type was total knee prosthesis (TKP) in 29 patients, unicondylar prosthesis in 2. The technical approach was ipsilateral in 33 procedures and contralateral in 5. All embolisations were performed using 4F diagnostic catheters, 2.7F microcatheters and microspheres (range: 100-500 μ). The technical endpoint was subtotal devascularisation in order to avoid ischemic complications. Clinical endpoint was symptomatic improvement. Results: Technical success was achieved 100%. In all cases, the superior lateral and medial genicular arteries could be embolised. In 12/38 procedures (32%), one or both inferior genicular arteries could not be catheterised due to the superposition of the TKP. Symptomatic improvement was achieved in 26/31 patiënts (84%). Post-procedural pain was noted in all patiënts, resolving inside 24 hrs in most. Two complications occurred, one low grade infection and one aseptic necrosis. Conclusions: Endovascular embolisation of genicular arteries is safe and efficient for the treatment of chronic hemarthrosis post knee prosthesis placement. Clinical improvement is seen in most patients. Complications are rare.

Publication History

Article published online:
26 April 2021

© 2017. The Arab Journal of Interventional Radiology. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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