Warfarin-associated intracapsular hemorrhage causing an acutely painful total hip arthroplasty - A rare complication of prolonged anticoagulant therapy

Hemorrhage is the most prevalent adverse effect of oral anticoagulant thera py. The incidence of bleeding complications is related to the duration and range of therapy. A patient on long-term warfarin anticoagulation developed a spontaneous intracapsular bleed into a total hip arthroplasty that had b een implanted 11 years before. Joint aspiration allowed early recognition w ith immediate resolution of symptoms. Diagnosis and treatment of this rare complication are discussed with a review of the literature.