Embolization of Genicular Arteries for Chronic Hemarthrosis Post Knee Prosthesis
Bibliographic record
Abstract
Background: Post-operative hemarthrosis after knee prosthesis can be invalidating due to painful swelling of the knee and diminished mobility. We describe the technique and clinical results of endovascular embolisation of genicular arteries. Methods: From 01.2007 until 12.2016, 31 patients were treated (17 m, 14 w) with a mean age of 67 y (range 48-90). A total of 38 embolisation procedures were performed (31-1, 5-2 and 1-3), 26 right and 12 left sided. The mean time from surgery to symptoms was 24, 4 months (range 1-64) and embolisation was 27,4 months (range 1-70). Surgery type was total knee prosthesis (TKP) in 29 patients, unicondylar prosthesis in 2. The technical approach was ipsilateral in 33 procedures and contralateral in 5. All embolisations were performed using 4F diagnostic catheters, 2.7F microcatheters and microspheres (range: 100-500 μ). The technical endpoint was subtotal devascularisation in order to avoid ischemic complications. Clinical endpoint was symptomatic improvement. Results: Technical success was achieved 100%. In all cases, the superior lateral and medial genicular arteries could be embolised. In 12/38 procedures (32%), one or both inferior genicular arteries could not be catheterised due to the superposition of the TKP. Symptomatic improvement was achieved in 26/31 patiënts (84%). Post-procedural pain was noted in all patiënts, resolving inside 24 hrs in most. Two complications occurred, one low grade infection and one aseptic necrosis. Conclusions: Endovascular embolisation of genicular arteries is safe and efficient for the treatment of chronic hemarthrosis post knee prosthesis placement. Clinical improvement is seen in most patients. Complications are rare. Publication History Article published online: 26 April 2021 © 2017. The Arab Journal of Interventional Radiology. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/). Thieme Medical and Scientific Publishers Pvt. Ltd. A-12, 2nd Floor, Sector 2, Noida-201301 UP, India
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.004 | 0.017 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.003 | 0.006 |
| Bibliometrics | 0.003 | 0.003 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".