RECURRENT HEMARTHROSIS AFTER TOTAL KNEE ARTHROPLASTY

Seven patients developed recurrent hemarthroses following total knee a rthroplasty. The average interval between arthroplasty and the first b leed was more than 20 months (range, 1-30 months). All seven required open synovectomy an average of 21 months (6-31 months) after arthropla sty. Follow-up evaluation averaged 44 months (19-60 months) and all ha d an excellent result without further bleeds. A prolific synovitis was seen in all cases, with histologic features revealing a chronic synov itis with fibrosis and hemosiderin staining. Entrapment of the prolife rative synovial tissue between the components is postulated to be the etiology for these recurrent bleeds which averaged four per patient pr ior to synovectomy.