A 62-year-old patient who underwent primary total knee replacement 5 years ago presents with recurrent haemarthrosis of the knee. Aspiration yields bloody fluid with no organisms and no crystals. What is the most appropriate initial definitive intervention?
- A Open synovectomy
- B Arthroscopic synovectomy or angiographic embolisation ✓
- C Two-stage revision arthroplasty
- D Arthrocentesis and corticosteroid injection
Correct answer: B. Arthroscopic synovectomy or angiographic embolisation
Explanation
Recurrent haemarthrosis after TKR without infection or mechanical cause is often due to synovial impingement or a vascularised synovial pouch. Arthroscopic synovectomy or selective angiographic embolisation is the standard initial intervention. Revision arthroplasty is reserved for refractory cases only.
Reference: Campbell's Operative Orthopaedics, 14th ed.
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