Minimally Invasive Approach to the Management of Recurrent Spontaneous Hemarthrosis After Total Knee Replacement: A Report of Two Cases

Spontaneous recurrent hemarthrosis of the knee after total knee arthroplasty is an infrequent complication. Early recognition and prompt diagnosis are essential to avoid issues such as joint stiffness, chronic pain, and limited mobility. Conservative treatment methods are often effective. However, in cases where the bleeding recurs, imaging studies like CT or MRI angiograms are necessary to confirm the diagnosis and guide treatment. We discuss two instances of spontaneous recurrent hemarthrosis that appeared six months and two years after total knee arthroplasty, both characterized by painful knee swelling and movement restriction. Following conservative management, both patients underwent CT angiograms and selective embolization, leading to excellent recovery without recurrence. In summary, selective arterial embolization of the genicular arteries is a minimally invasive, safe, and effective procedure for treating recurrent spontaneous hemarthrosis after total knee replacement.