A 68-year-old man develops sudden onset severe knee pain and hemarthrosis 2 days after uncomplicated total knee replacement. The most likely diagnosis is:
- A Periprosthetic joint infection
- B Aseptic loosening
- C Acute hemarthrosis from synovial impingement ✓
- D Arthrofibrosis
Correct answer: C. Acute hemarthrosis from synovial impingement
Explanation
Acute hemarthrosis within the first few days of total knee replacement, presenting with sudden severe pain and joint swelling, is most commonly caused by synovial impingement or a bleeding vessel in the retained synovium caught between moving components. Infection typically presents later (>2 weeks for acute hematogenous or 3 months for delayed types). Aseptic loosening and arthrofibrosis are delayed complications. Urgent aspiration and management of the bleeding source is required.
Reference: Maheshwari Essential Orthopaedics, 6th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.