VS15P
THERAPEUTIC EMBOLISATION IN THE TREATMENT OF RECURRENT HAEMARTHROSIS FOLLOWING KNEE ARTHROPLASTY

Recurrent spontaneous haemarthrosis after knee arthroplasty occurs in less than 1% of cases, commonly thought to be result of impingement of hypertrophic vascular synovium or fat pads, exacerbated by anticoagulation or antiplatelet agents. Traditional managements include conservative management with rest and ice initially, followed by open or arthroscopic washout and synovectomy if bleeding recurs or fail to settle. We present 3 cases of recurrent haemarthrosis following knee arthroplasties which were successfully treated with angiography and coil embolisation. Injuries to one of the genicular arteries were identified as the cause in all three cases with one manifesting in formation of a traumatic arteriovenous malformation. All cases were associated with resolution of symptoms with no recurrence (follow‐up period 6 months – 5 years, median of 2 years). We discuss the possibility that direct injury to genicular arteries and the development of subsequent complications including arteriovenous malformation and false aneurysm as more likely aetiology of recurrent bleeding.