Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Hemarthrosis”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 19 recordsLinked to original sources
PubMedDate not supplied

Effects of intra-articular vitamin E and corticosteroid injection in experimental hemarthrosis in rabbits.

The effects of intra-articular injections of vitamin E and corticosteroid were investigated in skeletally mature New Zealand white rabbits in which experimental hemarthrosis was induced for 14 days. The rabbits were divided into three groups composed of eight rabbits each: the first group comprised of animals with hemarthrosis, the second group animals with hemarthrosis and intra-articular injections of 20 mg vitamin E, and the third group animals with hemarthrosis and intra-articular injections of 10 mg of triamcinolone acetonide (TCA). Proteoglycan levels in the joint cartilage of the hemarthrosis group were found to be increased significantly compared with the controls (P < .01), whereas in the vitamin E-injected group they were significantly decreased (P < .05). In the TCA-injected group, proteoglycan levels were not found to be significantly different from those in the hemarthrosis group (P > .05). Histopathological evaluation showed that the cartilage structure in the joint of the control limbs was identical to that in the vitamin E- and TCA-injected limbs. In the hemarthrosis group, in comparison with the controls, the joint surface was roughened and fibrillated. In the superficial areas of the cartilage tissue, chondrocytes were decreased in number. These findings suggest that in this model, vitamin E and TCA may be helpful in preventing the joint cartilage changes seen in hemarthrosis.

Animals↗
PubMed1982

[Spontaneous hemarthrosis in adolescents and adults, excluding hemophilia].

The various etiologies of spontaneous hemarthrosis in adolescents and adults are reviewed: they include systemic diseases and local or regional disorders of the bones or joints. Among systemic diseases, the two main causes are coagulation disorders and hemoglobinopathies. Coagulation disorders may be either acquired (leukemia, thrombopenia, and hypoprothrombinemia induced by anticoagulant drugs with hemarthrosis being one of the major complications) or inherited (hemophilia which is not considered here, von Willebrand disease, and congenital thrombopathies). Hemoglobinopathies, particularly sickle-cell disease, are responsible for hemarthrosis in a few patients. Among local or regional disorders of the bones or joints, tumors such as hemangioma or synovial sarcoma are uncommon causes. Hemarthrosis is the main feature of pigmented villonodular synovitis. Hemarthrosis may occur in degenerative and metabolic diseases: while it is extremely rare in arthritis, it is frequently encountered in articular chondrocalcinosis which is the first diagnosis to consider when hemarthrosis occurs in an elderly patient. The search for an etiology, which is often difficult, should include a review of prior illnesses, a study of coagulation, and local clinical, radiological and biological investigations, with a study of the synovial fluid; in some instances, arthroscopy, synovial biopsy and even surgical exploration are required. Management includes rest, analgesics, antiinflammatory drugs and, above all, arthrocentesis which is essential for the prevention of articular damage and functional sequellae. Specific therapy is dependent on the etiology. In recurrent hemarthrosis, isotopic synoviorthesis may ensure lasting resolution of the effusion.

Adolescent↗
PubMed2007

In vitro multipotentiality and characterization of human unfractured traumatic hemarthrosis-derived progenitor cells: A potential cell source for tissue repair.

Mesenchymal progenitor cells (MPCs) are a very attractive tool in the context of repair and regeneration of musculoskeletal tissue damaged by trauma. The most common source of MPCs to date has been the bone marrow, but aspirating bone marrow from the patient is an invasive procedure. In an attempt to search for alternative sources of MPCs that could be obtained with minimal invasion, we looked into traumatic hemarthrosis of the knee. In this study, we determined whether a population of multipotent MPCs could be isolated from acute traumatic knee hemarthrosis in the absence of intra-articular fractures. Mononuclear cells were isolated from the aspirated hemarthrosis by density gradient separation, and cultured. We were able to obtain plastic adherent fibroblast-like cells from the mononuclear cell fractions. Flow cytometry analysis revealed that the adherent fibroblast-like cells were consistently positive for CD29, CD44, CD105, and CD166, and were negative for CD14, CD34, and CD45. These were similar to control bone marrow stromal cells. These cells could differentiate in vitro into osteogenic, adipogenic, and chondrogenic cells in the presence of lineage-specific induction factors. In conclusion, acute unfractured traumatic hemarthrosis of the knee contains MPCs with multipotentiality. Because knee hemarthrosis is easy to harvest with minimal pain and without unnecessary invasion, we regard hemarthrosis-derived cells as an additional progenitor cell source for future tissue engineering and cell-based therapy in knee injuries.

Adolescent↗
PubMed1982

[Hemarthrosis and cruciate ligaments - biomechanical studies. 1].

Experimental studies on animals were conducted in order to investigate the influence exerted by a posttraumatic hemarthrosis upon the cruciate ligaments. The cruciate ligaments used in this experimentation had partly been exposed only to a posttraumatic hemarthrosis, the other part showed an additional lesion of the synovial sheath. Further investigations were carried out in order to find out if the effect of the hemarthrosis is modified by a plaster immobilization of the concerned extremity. In a comparative study, cruciate ligaments which had been exposed to hemarthrosis for different periods of time and normal cruciate ligaments were submitted to mechanical tension which was exerted until rupture. By means of extensive pre-experiments it was possible to define the practical execution, the storage of the removed cruciate ligament preparations, and the general mechanical behavior of cruciate ligaments in rabbits. The study showed that all cruciate ligaments exposed to hemarthrosis presented at least a temporary significant reduction of their mechanical loading capacity. This reduction was even more significant in case of an additional lesion of the synovial sheath. In the first case, a restitution of the normal loading capacity was observed after 8 to 12 weeks, in the second case (additional lesion of the synovial sheath) after 12 to 16 weeks. These results were not improved by a plaster immobilization of the concerned extremity; on the contrary this caused rather a negative tendency.

Animals↗
PubMed1982

[Consequences of hemarthrosis for the knee joint (author's transl)].

The presence of an hemarthrosis generally is a sign of a particularly severe joint lesion. Arthrous alterations appearing post-traumatically can therefore be due to the extent of the joint lesion as well as to the accompanying hemarthrosis. A group of 24 young adult rabbits was submitted to morphologic examinations in order to find out in which way an isolated hemarthrosis can be responsible of degenerative cartilage alterations. At intervals of eight days each, 3 cm3 of their own blood were injected into both knee joints of the rabbits. One knee joint was immobilized, the other was mobile. The results prove that the hemarthrosis represents a considerable risk with regard to the trophism of the concerned joint. A direct enzymatic damage to the joint cartilage alone or in combination with trophical alterations appearing later on can lead to a formation and aggravation of arthrosis. The degenerative alterations are increased in an immobilized joint. Bearing in mind these alterations, the conclusion is drawn for clinical practice that the hemarthrosis has to be considered when establishing both diagnosis and therapy plan (punction, joint lavage, drainage, immobilization as early as possible).

Animals↗
PubMed1991

The effect of tourniquet use and hemovac drainage on postoperative hemarthrosis.

Postoperative hemarthrosis is the most common reported complication after arthroscopic knee surgery. The purpose of this study was to determine the effects of hemovac drainage and tourniquet use on the incidence of postoperative hemarthrosis. Sixty patients who had undergone arthroscopic knee surgery were divided into groups based on tourniquet use and whether a drain was used postoperatively. At follow-up, patients had range of motion recorded, and clinical assessment of their hemarthrosis (Grades 0 through 4). Patients who had a hemovac drain used postoperatively, and those patients who did not have a tourniquet used, had fewer hemarthroses and a greater range of motion at all periods of follow-up. We conclude that use of a drain can decrease the incidence of hemarthrosis and allow patients to regain an active range of motion sooner. Also, the routine use of a tourniquet should be avoided because of its correlation with hemarthrosis.

Adult↗
PubMed2006

An unusual meniscal ganglion cyst that triggered recurrent hemarthrosis of the knee.

A 58-year-old woman suffered spontaneous recurrent hemarthrosis of the knee. In the clinical course, pigmented villonodular synovitis was mostly suspected, but in arthroscopic surgery the lateral meniscus appeared to be upturned and stuck into the lateral pouch with the meniscal ganglion cyst. It was suggested that meniscal tear with meniscal ganglion cyst was related with recurrent hemarthrosis. Generally, both the meniscal ganglion cysts and spontaneous recurrent hemarthrosis are highly rare conditions. In this case, we speculated that a negligible power could induce the meniscal tear with recurrent hemarthrosis in the particular situation in which the meniscal ganglion cyst existed. In other words, the meniscal ganglion cyst might basically and physically relate with hemorrhagic condition. Arthroscopically, the meniscal ganglion cyst was removed together with the anterior segment of the lateral meniscus. Recurrent hemarthrosis was treated successfully by resection of the meniscus.

Arthroscopy↗
PubMed2005

Human hemarthrosis-derived progenitor cells can differentiate into osteoblast-like cells in vitro.

We hypothesized that intraarticular osteochondral fracture-induced hemarthrosis could be a useful cell source for bone regeneration, as it is thought to contain osteoprogenitor cells derived from bone marrow. Therefore, we investigated whether human hemarthrosis-derived cells have the potential to differentiate into osteoblast-like cells in vitro. We aspirated hemarthrosis from patients suffering from osteochondral fractures of knee joints, and cultured hemarthrosis-derived cells in a medium supplemented with dexamethasone, beta-glycerophosphate, and ascorbic acid, or without them as control. The morphology of the treated cells appeared to be cuboidal shape, differing from spindle-like shape observed in the control. Matrix mineralization was observed only in the treated culture. Alkaline phosphatase activity and gene expression of alkaline phosphatase, parathyroid hormone receptor, osteopontin, and osteocalcin were up-regulated compared with the control. These studies demonstrate that human hemarthrosis-derived cells can differentiate into osteoblast-like cells, i.e., they contain osteoprogenitor cells and are a useful cell source for bone regeneration.

Adolescent↗
PubMed1994

The effect of experimental hemarthrosis on joint stiffness and synovial histology in a rabbit model.

The effect of a single injection of unpreserved blood on joint stiffness and on synovial and cartilage histomorphology in the ankle joints of rabbits was determined at ten and 28 days after injection. The same volume of saline was placed in the contralateral ankle for comparison. After ten days, the hemarthrosis ankle was stiffer than the control ankle (p < 0.027), whereas at 28 days there was no statistical difference in stiffness between the hemarthrosis and control ankles, regardless of whether the limbs had been immobilized. Also after ten days, the hemarthrosis ankles had varying amounts of clotted blood, darkened articular cartilage, hypertrophic synovium with reactive blood vessels, and macrophages containing heme. The gross and histologic appearance of the saline ankles was normal. After 28 days, there were no differences in gross or microscopic appearance between the two ankles of the caged or immobilized rabbits. All ankles exhibited retreating inflammatory response in the synovium and mild synovial thickening. Acute hemarthrosis, unassociated with fracture or discernible joint injury, caused only transient changes in joint stiffness and synovial histology. These results indicate that the presence of blood in an otherwise grossly uninjured joint should not lead to ultimate compromise in cartilage integrity or joint function. Therapeutic arthrocentesis for acute posttraumatic hemarthrosis does not appear to be necessary for the prevention of permanent problems.

Animals↗
PubMedDate not supplied

Hemarthrosis associated with sodium warfarin therapy.

Three patients with hemarthrosis of the knee joint complicating sodium warfarin oral anticoagulation therapy are described. In all 3 the prothrombin time was at least 2.4 times the control value at the time of hemarthrosis. After initial bleeding was controlled, 2 patients had recurrences at times when their prothrombin times were again more than 2.5 times greater than those of the normal control subject. Joint symptoms persisted in all patients until the warfarin dose was substantially decreased or discontinued. Underlying joint disease was present in 1 individual and may have predisposed him to the occurrence of hemarthrosis. No long-term joint damage was recognized as resulting from the hemarthrosis at followup 1 to 2 years later. The authors conclude that hemathrosis associated with oral anticoagulant therapy occurs when the prothrombin time is excessively prolonged any may remain symptomatic until anticoagulation is reduced or discontinued. Management includes careful diagnostic aspiration, despite the prolonged prothrombin time, and discontinuation of anticoagulation.

Adult↗
PubMed2003

Hemarthrosis in acquired hemophilia. Two case-reports.

UNLABELLED: The many causes of hemarthrosis include acquired hemophilia due to production of autoantibodies to factor VIII. We report two very different cases. CASE 1: This woman experienced onset of juvenile idiopathic arthritis at 8 years of age. Her first child was born when she was 28-years-old. Three months after delivery, vaginal bleeding and recurrent hemarthrosis led to a diagnosis of acquired hemophilia (isolated APTT prolongation, 1% VIIIc activity, and 58 U of anti-factor VIII antibody). Treatment included glucocorticoid therapy, prothrombin complex, and intravenous immunoglobulins. She achieved a full recovery within a year. CASE 2: In this 84-year-old woman, spontaneous recurrent hemarthrosis with hematomas revealed idiopathic acquired hemophilia. Treatment included prothrombin complex, factor VIII concentrates, and intravenous immunoglobulins, followed by cyclophosphamide and glucocorticoid therapy. Recovery was complete within a year. The diagnosis, etiology, prognosis, and treatment of acquired hemophilia are discussed. CONCLUSION: Although rare, acquired hemophilia should be considered among the causes of hemarthrosis, particularly as a favorable outcome can be expected with early diagnosis and appropriate treatment.

Aged↗
PubMed2001

Atraumatic hemarthrosis caused by a large mediopatellar plica.

Hemarthrosis of the knee has various etiologies and is classified into atraumatic or post-traumatic. Among atraumatic factors, hemarthrosis due to synovial plica is extremely rare. We report a case of atraumatic hemarthrosis caused by the mediopatellar plica. A 21-year-old male truck driver was referred to our hospital, because of swelling and pain of the right knee without history of trauma. Bloody synovial fluid was aspirated by arthrocentesis. However, his symptoms recurred and persisted. The range of motion was normal, but the patient complained of anteromedial knee pain during maximum flexion. Routine biochemical analyses were within normal limits. Plain radiographs were normal. Magnetic resonance imaging (MRI) of the knee showed the hypertrophic mediopatellar plica and an irregular signal of the infrapatellar fat pad. Arthroscopy revealed a voluminous mediopatellar plica trapped between the patella and the medial femoral condyle. It attached to the center of the infrapatellar fat pad, the so-called tongue. When the tourniquet was released, fresh bleeding was observed from the region between the mediopatellar plica and the tongue. Because that region was considered to be the cause of the hemarthrosis, the mediopatellar plica and the tongue were excised. A histologic examination of the tongue showed evidence of bleeding with nonspecific synovitis. After the procedure, the patient was asymptomatic and there were no clinical signs of recurrence.

Adult↗
PubMed2005

Radiosynoviorthesis for treatment of hemophilic hemarthrosis--Slovenian experience.

UNLABELLED: Radiosynoviorthesis is a well-accepted method for the treatment of recurrent hemarthrosis in hemophilic patients. OBJECTIVES: The aims of our study were to evaluate the effectiveness of radiosynoviorthesis in patients suffering from hemophilic hemarthrosis, to determine the effect of treatment on antihemophilic factor consumption, and to assess the patient's satisfaction with radiosynoviorthesis. METHODS: Between 2001 and 2003, 26 radiosynoviortheses were done in 21 hemophilic patients; in 4 patients the treatment was repeated, and in 1 patient two joints were treated. 90Y colloid was used for the knee joint, and 186Re colloid was used for ankle, shoulder, and elbow radiosynoviorthesis. RESULTS: The bleeding frequency decreased by at least 50% in 53% of patients in the year after radiosynoviorthesis, as compared to the year prior to the therapy. Considering only those patients who had at least 12 bleedings into the treated joints in the year preceding the therapy, the bleeding frequency decreased by at least 50% in 62% of these patients. In this group, the consumption of the antihemophilic factor was notably reduced (on average, by 25,800 I.U./year). All patients reported that the treated joint was much better or better than before the radiosynoviorthesis. CONCLUSION: Radiosynoviorthesis is an effective method for the treatment of hemophilic hemarthrosis, particularly in patients with frequent intra-articular bleedings. The antihemophilic factor consumption was markedly reduced only in patients with frequent joint bleeding. Radiosynoviorthesis is well accepted by patients suffering from hemophilic hemarthrosis.

Adolescent↗
PubMed1990

Evaluation of acute traumatic hemarthrosis of the knee joint.

Acute hemarthrosis of the knee usually results from a significant injury. Preoperative assessment, examination under anesthesia, and arthroscopic examination were conducted on patients with a total of 132 acutely injured knees associated with hemarthrosis and minimal clinical laxity to determine the presence and extent of injury to ligamentous and/or intra-articular structures. Partial or complete tear of the anterior cruciate ligament was found in 101 (77%) of the knees. Peripheral meniscal tears were responsible for the hemarthrosis in 17 cases (13%), and osteochondral fractures were found in 11 cases (8%). Injury to the anterior cruciate ligament was frequently associated with concomitant injury to other structures: meniscal tears (61%), ligament/capsular injury (40%), and hyaline chondral damage (16%). Patients' responses to preoperative anterior drawer, pivot shift, and Lachman tests were within normal limits in 18%, 29%, and 73% of cases, respectively. Patients under anesthesia responded to the anterior drawer and pivot shift tests normally 50% and 74% of the time. The Lachman test, performed under anesthesia, was 98% accurate in predicting anterior cruciate injury. Experience gained in evaluating posttraumatic hemarthrosis of the knee suggests clinical examination alone may not demonstrate the severity of many of these injuries. Arthroscopy, although not necessary to determine competence of the anterior cruciate ligament, is invaluable in determining the existence of other injuries with or without an associated anterior cruciate ligament tear.

Acute Disease↗
PubMedDate not supplied

Acute hemarthrosis of the knee in children.

The purpose of this study was to determine the cause of acute hemarthrosis of the knee in a prospective pediatric patient population. Between December 1988 and August 1991, 21 consecutive children who were seen with an acute traumatic hemarthrosis of the knee had an arthroscopic evaluation. The average age of the children at the time of injury was 14 years, 3 months (range, 10 to 17 years). The mechanism of injury was a torsional strain to the knee in 12 (71%) of the 17 patients who could accurately remember the injury. The initial evaluation included a history, physical examination, and anteroposterior, lateral, sunrise, and comparison radiographs. The arthroscopic procedure was performed under general anesthesia, and the arthroscopic findings were compared with preoperative findings. During arthroscopic examination, an osteochondral fracture of the lateral femoral condyle or patella was identified in 14 (67%) of the 21 patients. Preoperative radiographs failed to identify the fracture in 5 (36%) of the 14 patients who had an osteochondral fracture. The anterior cruciate ligament was visualized and probed; an injury was found in only two cases (10%). We concluded that in children an acute traumatic hemarthrosis reflects a major injury to the knee. The children in this study had a high frequency of osteochondral fractures; ACL injuries were found in only two patients. Because of the unreliable nature of radiographic evaluation, arthroscopic evaluation is a valuable tool in differential diagnosis and treatment of acute hemarthrosis of the knee.

Acute Disease↗
PubMed1997

Hemarthrosis of the knee and bone contusion.

We present five patients with acute traumatic hemarthrosis of the knee who also had hemorrhage within the bone marrow around the knee detected by magnetic resonance imaging. No additional bony, ligamentous, meniscal or osteochondral injuries were evident from clinical examination, initial and repeated plain radiographs, or magnetic resonance imaging. The main symptoms were sharply localized pain and tenderness of the contused area. When hemarthrosis was demonstrated at the first office visit, three cases had fat droplets in the blood. Two patients with hemarthrosis of the knee undergoing arthroscopy showed no obvious lesions of intra-articular structures. Instead they showed congestion of the joint capsule located in accordance with the traumatic episode. Magnetic resonance imaging demonstrated marrow abnormalities as diffusely low and high signal intensity areas in T1-weighted and T2-weighted images, respectively, in locations consistent with the traumatic episode and the symptoms. These disappeared within an average of 13 weeks (range in 4 cases, 12 to 16 weeks). These findings were considered diagnostic of bone contusion. Symptom duration was about 2 weeks in all cases. In conclusion the clinician should consider the possibility of coexisting bone contusion in cases of acute traumatic hemarthrosis of the knee with no evidence of bone or intra-articular lesions on clinical examination and conventional radiographs.

Adolescent↗
PubMed1989

99mTc-DPD uptake in juvenile hemarthrosis. Scintimetry and autoradiography of the knee in dogs.

The pathogenesis of subchondral bone lesions and growth plate affection in hemophilic arthropathy was studied in puppies by means of repeated regional 99mTc-diphosphonate scintimetry and contact autoradiography. Unilateral hemarthrosis of the knee was induced by biweekly intraarticular injections of autologous blood for 12 weeks. Hemarthrosis caused an early (2 to 4 weeks) decrease in uptake of 99mTc-diphosphonate in the juxtaarticular growth plates (ratio 0.7) and a delayed (8 to 10 weeks) increase in epiphyseal uptake (ratio 1.5). In a recovery phase after hemarthrosis, growth plate uptake returned to normal, while the epiphyseal uptake remained elevated for 8 to 10 weeks. By contact autoradiography, the growth plate uptake was localized to the calcification layer at the metaphyseal aspect of the growth plates, while the epiphyseal uptake mainly was seen in the thin subchondral and subsynovial bone layer and around osteophytes. The changes in uptake of 99mTc-diphosphonate following hemarthrosis for 3 months were reversible and could be ascribed to the presence of synovial inflammation.

Animals↗
PubMed1992

Skeletal muscle function in patients with hemophilia A and unilateral hemarthrosis of the knee.

Acute hemarthrosis is a frequent complication of hemophilia A. To test the hypothesis that recurrent hemarthrosis has an adverse effect on neuromuscular function, ten patients with hemophilia A and history of unilateral hemarthrosis of the knee were studied. The uninvolved (U) side was used as the control. The time since diagnosis, factor level, and the number of bleeding episodes in the involved (I) knee averaged 11.6 +/- 6.6 years, 7.7 +/- 5.1%, and 7.0 +/- 7.4, respectively. Neuromuscular function was evaluated on a Cybex 340 isokinetic dynamometer. Knee extensor strength measured at 60 degrees/sec was significantly (p less than .05) lower in the I side (mean = 58Nm) than in the U side (mean = 85Nm). Similarly, lower (p less than .05) total work (I = 479J, U = 656J) and average power output (I = 59W, U = 83W) values were obtained. Adjusting for thigh circumference did not eliminate any of these differences. Testing the extensors at faster angular velocities (180 degrees/sec and 240 degrees/sec) and the flexor muscle groups at the three speeds revealed no differences between I and U. X-rays showed minimal changes. These data show that patients with hemophilia A and history of unilateral hemarthrosis of the knee have neuromuscular dysfunction in the I extremity that precedes the appearance of radiologic evidence of joint pathology. It is suggested that strength training should be started early in the rehabilitation of hemophiliacs.

Adolescent↗