{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T23:54:51Z","timestamp":1783036491376,"version":"3.54.6"},"reference-count":17,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,7,25]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n               <jats:p>Recurrent haemarthrosis after total knee arthroplasty (TKA) is a rare but challenging complication, with an incidence ranging from 0.3% to 1.6%. Conservative treatment, including rest, joint aspiration, and oral tranexamic acid, is often the first-line approach, but approximately two-thirds of cases require more invasive procedures. Genicular artery embolisation (GAE) has emerged as a promising alternative to synovectomy for refractory cases, offering high success rates with fewer complications. While most reports of GAE for recurrent haemarthrosis focus on patients with osteoarthritis, data on its use in patients with rheumatoid arthritis (RA) are scarce. We report a case of a 79-year-old woman with RA who presented with recurrent haemarthrosis 11\u00a0years after TKA. Despite conservative treatment, her haemarthrosis persisted. Angiography revealed three hypervascular areas supplied by branches of the superior lateral, superior medial, and middle genicular arteries. Embolisation was successfully performed using gelatin sponge, resulting in complete symptom resolution without recurrence at the 2-year follow-up. This case highlights the potential of GAE as a viable treatment option for recurrent haemarthrosis in patients with RA, particularly those with multiple bleeding sites or when synovectomy is unsuccessful or impractical. Careful evaluation from multiple angiographic angles is crucial to detect all bleeding sources, especially in post-TKA cases where metal implants may obscure vascular regions. Although further studies are needed, GAE may represent a safe and effective alternative for managing recurrent haemarthrosis in patients with RA.<\/jats:p>","DOI":"10.1093\/mrcr\/rxaf030","type":"journal-article","created":{"date-parts":[[2025,5,27]],"date-time":"2025-05-27T07:29:13Z","timestamp":1748330953000},"source":"Crossref","is-referenced-by-count":3,"title":["Successful treatment of recurrent haemarthrosis after total knee arthroplasty using genicular artery embolisation in a patient with rheumatoid arthritis"],"prefix":"10.1093","volume":"9","author":[{"given":"Mayu","family":"Iiboshi","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo , Tokyo ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroyasu","family":"Mizuhara","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo , Tokyo ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenta","family":"Makabe","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo , Tokyo ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasunori","family":"Omata","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo , Tokyo ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takeyuki","family":"Watadani","sequence":"additional","affiliation":[{"name":"Department of Radiology, Faculty of Medicine, The University of Tokyo , Tokyo ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9210-9414","authenticated-orcid":false,"given":"Sakae","family":"Tanaka","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo , Tokyo ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2363-9803","authenticated-orcid":false,"given":"Takumi","family":"Matsumoto","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo , Tokyo ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,5,28]]},"reference":[{"key":"2025080201021729700_ref1","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1016\/j.arth.2003.09.009","article-title":"Recurrent hemarthrosis after knee joint arthroplasty: etiology and treatment","volume":"19","author":"Ohdera","year":"2004","journal-title":"J Arthroplast"},{"key":"2025080201021729700_ref2","doi-asserted-by":"crossref","first-page":"147","DOI":"10.5792\/ksrr.17.059","article-title":"Treatment of recurrent hemarthrosis after total knee arthroplasty","volume":"30","author":"Yoo","year":"2018","journal-title":"Knee Surg Relat Res"},{"key":"2025080201021729700_ref3","doi-asserted-by":"crossref","first-page":"652","DOI":"10.5435\/JAAOS-D-18-00182","article-title":"Recurrent hemarthrosis after total knee arthroplasty: evaluation and treatment","volume":"27","author":"Ravi","year":"2019","journal-title":"J Am Acad Orthop Surg"},{"key":"2025080201021729700_ref4","doi-asserted-by":"crossref","first-page":"S52","DOI":"10.1016\/S0883-5403(05)80231-1","article-title":"Recurrent hemarthrosis after total knee arthroplasty","volume":"10","author":"Kindsfater","year":"1995","journal-title":"J Arthroplast"},{"key":"2025080201021729700_ref5","doi-asserted-by":"crossref","first-page":"977","DOI":"10.1016\/S0883-5403(96)80144-6","article-title":"Recurrent hemarthrosis after total knee arthroplasty","volume":"11","author":"Worland","year":"1996","journal-title":"J Arthroplast"},{"key":"2025080201021729700_ref6","doi-asserted-by":"crossref","first-page":"267","DOI":"10.1007\/s11999-015-4476-6","article-title":"Is embolization an effective treatment for recurrent hemorrhage after hip or knee arthroplasty?","volume":"474","author":"Kalmar","year":"2016","journal-title":"Clin Orthop Relat Res"},{"key":"2025080201021729700_ref7","doi-asserted-by":"crossref","first-page":"1177","DOI":"10.1016\/j.arth.2017.11.002","article-title":"Embolization of the geniculate arteries is an effective treatment of recurrent hemarthrosis following total knee arthroplasty that can be safely repeated","volume":"33","author":"Baardewijk","year":"2018","journal-title":"J Arthroplast"},{"key":"2025080201021729700_ref8","doi-asserted-by":"crossref","first-page":"2050313x20964116","DOI":"10.1177\/2050313X20964116","article-title":"Recurrent hemarthrosis after total knee arthroplasty in rheumatoid arthritis successfully treated with selective embolization: a case report","volume":"8","author":"Mammoto","year":"2020","journal-title":"SAGE Open Med Case Rep"},{"key":"2025080201021729700_ref9","doi-asserted-by":"crossref","first-page":"216","DOI":"10.1007\/s00270-016-1511-2","article-title":"Endovascular management of recurrent spontaneous hemarthrosis after arthroplasty","volume":"40","author":"Kolber","year":"2017","journal-title":"Cardiovasc Intervent Radiol"},{"key":"2025080201021729700_ref10","doi-asserted-by":"crossref","first-page":"617","DOI":"10.1016\/j.knee.2013.10.012","article-title":"Recurrent hemarthrosis after total knee arthroplasty caused by the impingement of a remnant lateral meniscus: a case report","volume":"21","author":"Kawata","year":"2014","journal-title":"Knee"},{"key":"2025080201021729700_ref11","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1148\/rg.210159","article-title":"Geniculate artery embolization: role in knee hemarthrosis and osteoarthritis","volume":"42","author":"Heller","year":"2022","journal-title":"Radiographics"},{"key":"2025080201021729700_ref12","doi-asserted-by":"crossref","first-page":"2004","DOI":"10.1016\/j.arth.2015.05.028","article-title":"Recurrent hemarthrosis following knee arthroplasty treated with arterial embolization","volume":"30","author":"Weidner","year":"2015","journal-title":"J Arthroplast"},{"key":"2025080201021729700_ref13","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1186\/s42155-020-00135-0","article-title":"Endovascular management of recurrent hemarthrosis of the knee: a case series","volume":"3","author":"Pow","year":"2020","journal-title":"CVIR Endovasc"},{"key":"2025080201021729700_ref14","doi-asserted-by":"crossref","first-page":"229","DOI":"10.3892\/etm.2023.11928","article-title":"Experimental study of the effects of absorbable gelatin sponge and non-absorbable polyvinyl alcohol particle material used in transcatheter arterial embolization on liver tissues","volume":"25","author":"Liu","year":"2023","journal-title":"Exp Ther Med"},{"key":"2025080201021729700_ref15","doi-asserted-by":"crossref","first-page":"1005","DOI":"10.1002\/jbm.a.31152","article-title":"Five types of inflammatory arthritis following total knee arthroplasty","volume":"81","author":"Niki","year":"2007","journal-title":"J Biomed Mater Res A"},{"key":"2025080201021729700_ref16","doi-asserted-by":"crossref","first-page":"371","DOI":"10.1007\/s10396-017-0806-5","article-title":"Certolizumab pegol was effective for treating residual synovitis after total knee arthroplasty in a patient with rheumatoid arthritis: therapeutic monitoring by ultrasound","volume":"45","author":"Kawashiri","year":"2018","journal-title":"J Med Ultrason"},{"key":"2025080201021729700_ref17","doi-asserted-by":"crossref","first-page":"280","DOI":"10.1093\/mr\/roae074","article-title":"Ultrasound-detected knee synovitis in patients with rheumatoid arthritis after total knee arthroplasty","volume":"35","author":"Miyoshi","year":"2025","journal-title":"Mod Rheumatol"}],"container-title":["Modern Rheumatology Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/mrcr\/advance-article-pdf\/doi\/10.1093\/mrcr\/rxaf030\/63390522\/rxaf030.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/mrcr\/article-pdf\/9\/2\/rxaf030\/63390522\/rxaf030.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/mrcr\/article-pdf\/9\/2\/rxaf030\/63390522\/rxaf030.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,2]],"date-time":"2025-08-02T05:02:26Z","timestamp":1754110946000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/mrcr\/article\/doi\/10.1093\/mrcr\/rxaf030\/8152009"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025]]},"references-count":17,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2025,7,25]]}},"URL":"https:\/\/doi.org\/10.1093\/mrcr\/rxaf030","relation":{},"ISSN":["2472-5625"],"issn-type":[{"value":"2472-5625","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2025]]},"published":{"date-parts":[[2025]]},"article-number":"rxaf030"}}