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Title: Endovascular Management of Recurrent Spontaneous Hemarthrosis After Arthroplasty

Abstract

PurposeRecurrent spontaneous hemarthrosis is an infrequent but debilitating late complication of joint replacement, affecting up to 1.6% of patients with arthroplasty of the affected joint. Repeated episodes of bleeding result in an inflammatory cascade that further propagates bleeding events. Open and arthroscopic synovectomy are often performed when conservative treatments fail. Transarterial embolization is increasingly utilized as a less invasive option; however, its role is not widely established. We performed a systematic literature review to report the safety and efficacy of transarterial embolization in treating recurrent hemarthrosis in the setting of prior arthroplasty.Materials and MethodsA systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines. A structured search was performed in PubMed, Web of Science, Embase, and SCOPUS databases of patients undergoing embolization for recurrent hemarthrosis after arthroplasty. Patients immediately post-operative, those embolized at first bleeding episode, and those with hemophilia were excluded. Demographic data, clinical information, angiographic findings, treatment, and outcomes were tabulated.ResultsThe search identified 119 titles of which 24 were deemed relevant, comprising 91 patients undergoing 99 embolization procedures. Mean time from prosthesis implantation was 32.2 months. Technical success was 99%. Mean follow-up time was 24.9 months. There were 10 recurrences (10%). Two casesmore » were complicated by joint infection requiring arthroplasty revision.ConclusionsTransarterial embolization for recurrent spontaneous hemarthrosis may be safe and effective in patients having undergone arthroplasty of the affected joint.« less

Authors:
; ; ; ; ;  [1]
  1. Mount Sinai Beth Israel, Division of Vascular and Interventional Radiology, Department of Radiology (United States)
Publication Date:
OSTI Identifier:
22645327
Resource Type:
Journal Article
Resource Relation:
Journal Name: Cardiovascular and Interventional Radiology; Journal Volume: 40; Journal Issue: 2; Other Information: Copyright (c) 2017 Springer Science+Business Media New York and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE); http://www.springer-ny.com; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; BONE JOINTS; HEMOPHILIA; INFLAMMATION; INFORMATION; MATERIALS; PATIENTS; PROSTHESES; RECOMMENDATIONS; REVIEWS; SAFETY; SKELETAL DISEASES; VASCULAR DISEASES

Citation Formats

Kolber, Marcin K., Shukla, Pratik A., Kumar, Abhishek, Zybulewski, Adam, Markowitz, Todd, and Silberzweig, James E., E-mail: jsilberzweig@chpnet.org. Endovascular Management of Recurrent Spontaneous Hemarthrosis After Arthroplasty. United States: N. p., 2017. Web. doi:10.1007/S00270-016-1511-2.
Kolber, Marcin K., Shukla, Pratik A., Kumar, Abhishek, Zybulewski, Adam, Markowitz, Todd, & Silberzweig, James E., E-mail: jsilberzweig@chpnet.org. Endovascular Management of Recurrent Spontaneous Hemarthrosis After Arthroplasty. United States. doi:10.1007/S00270-016-1511-2.
Kolber, Marcin K., Shukla, Pratik A., Kumar, Abhishek, Zybulewski, Adam, Markowitz, Todd, and Silberzweig, James E., E-mail: jsilberzweig@chpnet.org. Wed . "Endovascular Management of Recurrent Spontaneous Hemarthrosis After Arthroplasty". United States. doi:10.1007/S00270-016-1511-2.
@article{osti_22645327,
title = {Endovascular Management of Recurrent Spontaneous Hemarthrosis After Arthroplasty},
author = {Kolber, Marcin K. and Shukla, Pratik A. and Kumar, Abhishek and Zybulewski, Adam and Markowitz, Todd and Silberzweig, James E., E-mail: jsilberzweig@chpnet.org},
abstractNote = {PurposeRecurrent spontaneous hemarthrosis is an infrequent but debilitating late complication of joint replacement, affecting up to 1.6% of patients with arthroplasty of the affected joint. Repeated episodes of bleeding result in an inflammatory cascade that further propagates bleeding events. Open and arthroscopic synovectomy are often performed when conservative treatments fail. Transarterial embolization is increasingly utilized as a less invasive option; however, its role is not widely established. We performed a systematic literature review to report the safety and efficacy of transarterial embolization in treating recurrent hemarthrosis in the setting of prior arthroplasty.Materials and MethodsA systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines. A structured search was performed in PubMed, Web of Science, Embase, and SCOPUS databases of patients undergoing embolization for recurrent hemarthrosis after arthroplasty. Patients immediately post-operative, those embolized at first bleeding episode, and those with hemophilia were excluded. Demographic data, clinical information, angiographic findings, treatment, and outcomes were tabulated.ResultsThe search identified 119 titles of which 24 were deemed relevant, comprising 91 patients undergoing 99 embolization procedures. Mean time from prosthesis implantation was 32.2 months. Technical success was 99%. Mean follow-up time was 24.9 months. There were 10 recurrences (10%). Two cases were complicated by joint infection requiring arthroplasty revision.ConclusionsTransarterial embolization for recurrent spontaneous hemarthrosis may be safe and effective in patients having undergone arthroplasty of the affected joint.},
doi = {10.1007/S00270-016-1511-2},
journal = {Cardiovascular and Interventional Radiology},
number = 2,
volume = 40,
place = {United States},
year = {Wed Feb 15 00:00:00 EST 2017},
month = {Wed Feb 15 00:00:00 EST 2017}
}