Journal of Clinical Cases

A Case Of Pigmented Villonodular Synovitis With Recurrent Hemarthrosis After Total Knee Arthroplasty

Gamze Yavuz Ozerdem

1. Department of Medicine, Turkey.

Corresponding Author: Gamze Yavuz Ozerdem

ABSTRACT

Introduction:Recurrent hemarthrosis (RH) is a rare condition occurring after total knee arthroplasty (TKA), with an incidence ranging from 0.1% to 1.6%. Both systemic and local factors contribute to the etiology of RH. Among systemic factors are the use of anticoagulants and blood dyscrasias, while local factors include iatrogenic causes such as implant malposition and vascular injury, trauma, infective or pigmented villonodular synovitis (PVNS), implant loosening, vascular anomalies, and soft tissue impingement (1, 2). Pigmented villonodular synovitis is a proliferative process that affects the synovial joints, tendon sheaths, and bursae, with an annual incidence rate of 1.8 per 1,000,000. PVNS is a rare complication after TKA. The etiology of PVNS remains uncertain, but recurrent bleeding, neoplasm, and trauma are among the considered causes. The most appropriate treatment for PVNS involves surgical excision of the pathological tissue (3). Several cases of PVNS presenting with RH after TKA have been reported in the literature (4-7). In these cases, PVNS appeared 12 months to 9 years after TKA. Here, we present our patient who presented with symptoms of RH after TKA, was diagnosed with PVNS, and was treated with synovectomy. The most significant difference in our case compared to others is that the post-TKA symptoms started earlier, at 4 months.