An Unusual Presentation of Delayed Hemarthrosis Following Total Knee Arthroplasty: A Case Report

Introduction: Vascular complications following Total Knee Arthroplasty (TKA) are rare but can be potentially life-threatening. This case report describes a rare vascular complication after an elective TKA that was successfully managed with minimally invasive interventional radiology. Case Report: We...

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Main Authors: Rudra Prabhu, Sneha Pimpalnerkar, Ashvin Pimpalnerkar, Vijay Gudla, Arul Ganeshan
Format: Article
Language:English
Published: Indian Orthopaedic Research Group 2025-08-01
Series:Journal of Orthopaedic Case Reports
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Online Access:https://jocr.co.in/wp/2025/08/01/an-unusual-presentation-of-delayed-hemarthrosis-following-total-knee-arthroplasty-a-case-report/
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author Rudra Prabhu
Sneha Pimpalnerkar
Ashvin Pimpalnerkar
Vijay Gudla
Arul Ganeshan
author_facet Rudra Prabhu
Sneha Pimpalnerkar
Ashvin Pimpalnerkar
Vijay Gudla
Arul Ganeshan
author_sort Rudra Prabhu
collection DOAJ
description Introduction: Vascular complications following Total Knee Arthroplasty (TKA) are rare but can be potentially life-threatening. This case report describes a rare vascular complication after an elective TKA that was successfully managed with minimally invasive interventional radiology. Case Report: We describe the case of a 79-year-old hypertensive male who underwent a left elective primary cemented TKA. 10 days postoperatively, he presented with acute-onset pain and swelling of his left knee, lower thigh, and calf. An initial ultrasound scan ruled out deep vein thrombosis but demonstrated a large organized hematoma anterior to the femur with no active bleeding. Due to persistent pain and swelling, the patient underwent an arthroscopic washout and evacuation of the hematoma. Post-procedure, he developed recurrent knee hemarthrosis. Repeat ultrasound scan and angiography revealed the formation of a pseudoaneurysm due to active bleeding from the superior medial genicular artery. This was successfully managed with fluoroscopic embolization. At the final follow-up of 1 year, the patient was pain-free and had a good knee range of motion. He had made excellent progress in terms of daily living and quality of life. Conclusion: Pseudoaneurysms of the superior medial genicular artery are extremely rare complications following TKA. They can present as painful and recurrent hemarthrosis and can be effectively managed with minimally invasive interventional radiology, avoiding the complications and morbidity of traditional open repair.
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spelling doaj-art-edf2531748dd487f92f91d1b1e60e8a12025-08-20T04:01:02ZengIndian Orthopaedic Research GroupJournal of Orthopaedic Case Reports2250-06852321-38172025-08-0115811111510.13107/jocr.2025.v15.i08.5904An Unusual Presentation of Delayed Hemarthrosis Following Total Knee Arthroplasty: A Case ReportRudra PrabhuSneha PimpalnerkarAshvin PimpalnerkarVijay GudlaArul GaneshanIntroduction: Vascular complications following Total Knee Arthroplasty (TKA) are rare but can be potentially life-threatening. This case report describes a rare vascular complication after an elective TKA that was successfully managed with minimally invasive interventional radiology. Case Report: We describe the case of a 79-year-old hypertensive male who underwent a left elective primary cemented TKA. 10 days postoperatively, he presented with acute-onset pain and swelling of his left knee, lower thigh, and calf. An initial ultrasound scan ruled out deep vein thrombosis but demonstrated a large organized hematoma anterior to the femur with no active bleeding. Due to persistent pain and swelling, the patient underwent an arthroscopic washout and evacuation of the hematoma. Post-procedure, he developed recurrent knee hemarthrosis. Repeat ultrasound scan and angiography revealed the formation of a pseudoaneurysm due to active bleeding from the superior medial genicular artery. This was successfully managed with fluoroscopic embolization. At the final follow-up of 1 year, the patient was pain-free and had a good knee range of motion. He had made excellent progress in terms of daily living and quality of life. Conclusion: Pseudoaneurysms of the superior medial genicular artery are extremely rare complications following TKA. They can present as painful and recurrent hemarthrosis and can be effectively managed with minimally invasive interventional radiology, avoiding the complications and morbidity of traditional open repair.https://jocr.co.in/wp/2025/08/01/an-unusual-presentation-of-delayed-hemarthrosis-following-total-knee-arthroplasty-a-case-report/total knee arthroplastypseudoaneurysmrecurrent hemarthrosissuperior medial genicular arterydeep vein thrombosisangiography
spellingShingle Rudra Prabhu
Sneha Pimpalnerkar
Ashvin Pimpalnerkar
Vijay Gudla
Arul Ganeshan
An Unusual Presentation of Delayed Hemarthrosis Following Total Knee Arthroplasty: A Case Report
Journal of Orthopaedic Case Reports
total knee arthroplasty
pseudoaneurysm
recurrent hemarthrosis
superior medial genicular artery
deep vein thrombosis
angiography
title An Unusual Presentation of Delayed Hemarthrosis Following Total Knee Arthroplasty: A Case Report
title_full An Unusual Presentation of Delayed Hemarthrosis Following Total Knee Arthroplasty: A Case Report
title_fullStr An Unusual Presentation of Delayed Hemarthrosis Following Total Knee Arthroplasty: A Case Report
title_full_unstemmed An Unusual Presentation of Delayed Hemarthrosis Following Total Knee Arthroplasty: A Case Report
title_short An Unusual Presentation of Delayed Hemarthrosis Following Total Knee Arthroplasty: A Case Report
title_sort unusual presentation of delayed hemarthrosis following total knee arthroplasty a case report
topic total knee arthroplasty
pseudoaneurysm
recurrent hemarthrosis
superior medial genicular artery
deep vein thrombosis
angiography
url https://jocr.co.in/wp/2025/08/01/an-unusual-presentation-of-delayed-hemarthrosis-following-total-knee-arthroplasty-a-case-report/
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