A Review of Current Management of Knee Hemarthrosis in the Non-Hemophilic Population

• Authors: Nikhil Potpally, Rutgers New Jersey Medical School; Scott Rodeo, Hospital for Special Surgery; Paul So, Rutgers New Jersey Medical School; Kenneth Mautner, Emory University; Michael Baria, Ohio State University; Gerard A Malanga, Rutgers New Jersey Medical School
• Journal Title: CARTILAGE
• Volume: Volume 13, Number 1_SUPPL
• Publisher: SAGE PUBLICATIONS INC | 2020-07-22, Pages 116S-121S
• Type of Work: Article | Final Publisher PDF
• Publisher DOI: http://doi.org/10.1177/1947603520942937
• Subjects: Health Sciences, Medicine and Surgery
• Keywords: Science & Technology; Life Sciences & Biomedicine; Orthopedics; knee hemarthrosis; youth; joint injury; posttraumatic osteoarthritis; JOINT ASPIRATION; CARTILAGE DAMAGE; CHILDREN; BLOOD; GUIDELINES; SYNOVITIS; INJURIES; ADULTS

Abstract

The knee joint is one of the most frequently injured joints in the body, and the resulting injury may often lead to the presence of a bloody effusion, or hemarthrosis. The acute management of this condition can have long-lasting implications, and may ultimately result in the early onset of osteoarthritis in this population. Heme, a breakdown product of erythrocytes, and associated pro-inflammatory mediators, are known to have deleterious interactions with cartilage and synovium. The presence of blood in a joint following injury can precipitate these effects and accelerate the degenerative changes in the joint. Currently, there is no consensus on the optimal management of a traumatic knee joint injury with a hemarthrosis. Nontraumatic hemarthosis, seen most commonly in hemophilia patients, has a set of established guidelines that does not routinely recommend drainage of the joint. This article presents a rationale for joint aspiration to minimize the harmful effects of blood following traumatic hemarthrosis.