Previous studies reported MCL injury and haemarthrosis
as the most commonly associated pathology.
This bleeding disorder is rare and surprisingly less severe than haemophilia, where 20% of patients develop haemarthrosis
. Patients generally present with bleeding at mucosal sites, e.g.
When synovitis becomes chronic, the condition is worsened by the recurrent haemarthrosis
episodes, accelerating the degenerative process known as haemophilic arthropathy, which leads to alterations of the joints, pain, muscular atrophy, and functional impairment .
Kindsfater showed a mean time at presentation of haemarthrosis
at 2 years after arthroplasty.
This finding remains to be explained as to why this symptom is more frequent in RIBD than in hemophilia A and B, where haemarthrosis
is the most common symptom.
The WFH reported haemarthrosis
(70-80%), muscle haematoma (10-20%), other bleeding (5-10%) and intracranial bleeding as < 5%.
Acute patellar dislocations account for about 3% of all knee injuries and are the second most common cause of knee haemarthrosis
. However, there is as yet no consensus regarding treatment of acute patellar dislocation.10 In our case, we decided to perform surgery because of accompanying ligament injuries and we feel that the results are better with operative compared to non-operative treatment.
In the present case, we performed total knee replacement (due to osteoarthritis) in a patient with recurrent haemarthrosis
. However, during the operation, we observed severe black colouration of the knee articular cartilage, due to the deposition of hemosiderin and lipofuscin after the recurrent haemarthrosis
Common causes of joint pain * Reactive arthritis * Juvenile idiopathic arthritis * Septic arthritis/osteomyelitis * Haemarthrosis
In some seriously injured patients having haemarthrosis
, aspiration of the fluid with gentle lavage may render them more comfortable.
It may also be difficult to operate on any patient with a recent haemarthrosis
as visualisation may be compromised.
The presence of a knee haemarthrosis
(Table II) is positive for an ACL injury in 70% of cases.