Recurrent Hemarthroses After TKA Treated With an Intraarticular Injection of Yttrium-90
Identifieur interne : 000A09 ( Pmc/Curation ); précédent : 000A08; suivant : 000A10Recurrent Hemarthroses After TKA Treated With an Intraarticular Injection of Yttrium-90
Auteurs : Stephen Fine [Australie] ; Alex Klestov [Australie]Source :
- Clinical Orthopaedics and Related Research [ 0009-921X ] ; 2015.
Abstract
Recurrent hemarthroses after a TKA are uncommon and usually respond to nonoperative treatment or intervention using angiographic embolization or synovectomy. However, in rare circumstances, the problem can be resistant to treatment.
We report the case of a patient who had recurrent hemarthroses after a TKA. During the first 18 months after surgery, the patient experienced 48 episodes consistent with bleeding into the knee. The bleeding episodes recurred despite use of traditional treatments, including arthroscopy, open synovectomy and embolization of a small, false aneurysm. The patient ultimately received an intraarticular injection of yttrium-90 silica/citrate, and the hemarthroses ceased soon after the injection. At last review, 25 months after the injection, the patient had experienced no additional bleeding episodes.
On review of the literature, we found only one other report in which yttrium-90 was used successfully in a similar situation.
Yttrium-90 may be considered a treatment option in patients with recurrent hemarthroses after TKA, especially when the condition has not responded to more traditional treatments. The long-term risk of treatment with yttrium-90 for recurrent hemarthroses after a TKA remains unclear.
Url:
DOI: 10.1007/s11999-015-4217-x
PubMed: 25712866
PubMed Central: 4746159
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<front><journal-meta><journal-id journal-id-type="nlm-ta">Clin Orthop Relat Res</journal-id><journal-id journal-id-type="iso-abbrev">Clin. Orthop. Relat. Res</journal-id><journal-title-group><journal-title>Clinical Orthopaedics and Related Research</journal-title></journal-title-group><issn pub-type="ppub">0009-921X</issn><issn pub-type="epub">1528-1132</issn><publisher><publisher-name>Springer US</publisher-name><publisher-loc>New York</publisher-loc></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">25712866</article-id><article-id pub-id-type="pmc">4746159</article-id><article-id pub-id-type="publisher-id">4217</article-id><article-id pub-id-type="doi">10.1007/s11999-015-4217-x</article-id><article-categories><subj-group subj-group-type="heading"><subject>Case Report</subject></subj-group></article-categories><title-group><article-title>Recurrent Hemarthroses After TKA Treated With an Intraarticular Injection of Yttrium-90</article-title></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name><surname>Fine</surname><given-names>Stephen</given-names></name><degrees>MBBCh, FRACS</degrees><address><email>fineshar@bigpond.com</email></address><xref ref-type="aff" rid="Aff1"></xref></contrib><contrib contrib-type="author"><name><surname>Klestov</surname><given-names>Alex</given-names></name><degrees>MBBS, BSc, FRACP</degrees><xref ref-type="aff" rid="Aff2"></xref></contrib><aff id="Aff1"><label></label>Department of Orthopaedic Surgery, Greenslopes Private Hospital, Newdegate Street, Greenslopes, Brisbane, 4120 Australia</aff><aff id="Aff2"><label></label>Rheumatology Department, Royal Brisbane and Women’s Hospital, Herston, Brisbane, Australia</aff></contrib-group><pub-date pub-type="epub"><day>25</day><month>2</month><year>2015</year></pub-date><pub-date pub-type="ppub"><month>3</month><year>2016</year></pub-date><volume>474</volume><issue>3</issue><fpage>850</fpage><lpage>853</lpage><history><date date-type="received"><day>15</day><month>11</month><year>2014</year></date><date date-type="accepted"><day>17</day><month>2</month><year>2015</year></date></history><permissions><copyright-statement>© The Association of Bone and Joint Surgeons® 2015</copyright-statement></permissions><abstract id="Abs1"><sec><title>Background</title><p>Recurrent hemarthroses after a TKA are uncommon and usually respond to nonoperative treatment or intervention using angiographic embolization or synovectomy. However, in rare circumstances, the problem can be resistant to treatment.</p></sec><sec><title>Case Description</title><p>We report the case of a patient who had recurrent hemarthroses after a TKA. During the first 18 months after surgery, the patient experienced 48 episodes consistent with bleeding into the knee. The bleeding episodes recurred despite use of traditional treatments, including arthroscopy, open synovectomy and embolization of a small, false aneurysm. The patient ultimately received an intraarticular injection of yttrium-90 silica/citrate, and the hemarthroses ceased soon after the injection. At last review, 25 months after the injection, the patient had experienced no additional bleeding episodes.</p></sec><sec><title>Literature Review</title><p>On review of the literature, we found only one other report in which yttrium-90 was used successfully in a similar situation.</p></sec><sec><title>Clinical Relevance</title><p>Yttrium-90 may be considered a treatment option in patients with recurrent hemarthroses after TKA, especially when the condition has not responded to more traditional treatments. The long-term risk of treatment with yttrium-90 for recurrent hemarthroses after a TKA remains unclear.</p></sec></abstract><custom-meta-group><custom-meta><meta-name>issue-copyright-statement</meta-name><meta-value>© The Association of Bone and Joint Surgeons® 2016</meta-value></custom-meta></custom-meta-group></article-meta></front></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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