Synovitis and Arthrofibrosis: Post-Op Internal Bleeding

Adhesions, internal scarring, fat pad syndrome, infrapatellar contracture, patella infera (baja)
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minister
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Synovitis and Arthrofibrosis: Post-Op Internal Bleeding

Post by minister »

Hi all,

I am glad to have found this forum. Would be nice to see if someone can throw some light into my story.

I (40M) suffer from chondromalacia patella grade 3 in my left knee (with small ulceration), I imagine due to old injury that caused vmo weakness and patellar maltracking. Out of nowhere, I started suffering a strange pain (which now I think it was synovitis) and reduced rom. Somehow looks like slowly I started developing adhesions and arthrofibrosis. Pain and rom got so bad that my OS said I needed surgery to clean everything up.

Scope 5 weeks ago showed synovitis with patellar and trochlear hypertrophy + arthrofibrosis everywhere. All was cleaned up with synovectomy of inflamed/thickened areas.

Recovery is being very slow. Extension and flexion are good and improving, but my quads shut down badly (I already had a weak vmo). The main problem is that I keep getting fluid/blood into the knee. Every week my OS has to drain it, and looks like it's just pure blood. After a couple of days knee gets swollen and hard again. He says sometimes it happens, might be small blood vessels after scrapping the synovium. As you can imagine, that swelling is interfering with my ability to recover my rom and quads, also I am worried of the continuous bleeding, as I read is bad for your joint and cartilage.

Would be good to know if someone else had this or a similar issue. Thanks in advance!

Regards,
Last edited by minister on Sat Feb 20, 2021 9:06 pm, edited 1 time in total.
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DogfacedGirl
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Re: Synovitis and Arthrofibrosis: Post-Op Internal Bleeding

Post by DogfacedGirl »

Hi Minister,

I haven't had your problem with persistent bleeding, but I do have a lot of experience and knowledge of AF. You are correct that continuous bleeding is a serious problem, both in creating more scar tissue and for OA. The fact that you still have bleeding so long after surgery points to a problem with the clotting process, with a component that is missing or dysfunctional.

The process that stops bleeding is a complex interplay between blood vessels (structure, constriction), platelets (needed to form a clump, maybe be lacking in number or function) and coagulation factors (many components). Some bleeding disorders can be caused by vitamin K deficiency, others are inherited etc.

It is possible that you've had minor bleeding into your joint from your old injury, which caused the initial fibrosis and damage. A minor bleeding disorder may easily have "flown under the radar" until now. I know of others with AF who have excessive or deficient clotting, both can be strong drivers of AF.

I suggest you get referred to a haematologist asap to determine the cause of your bleeding. If a cause is found usually something can be done to help stop the bleeding.

Also, I suggest that you back right off any leg exercises you're currently doing, as this will increase bleeding. Gentle stretching to maintain ROM should be OK. Exercises can be picked up again later when it is safe to do so.

Take care,

Kay
1999 Osteoarthritis both knees, chondroplasty
2004 MACI graft L knee
2005 MACI graft both knees
2007 MACI graft R knee
2007 Patella baja
2011 TKR both knees
2011 arthrofibrosis
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Re: Synovitis and Arthrofibrosis: Post-Op Internal Bleeding

Post by minister »

Hi Kay,

Thanks for your message. This week the aspiration was much clearer in colour and thinner. Dr will be sending me for further blood tests to look into those parameters if things don't improve soon. Also I will be taking it easy with exercises, just ROM and straight leg vmo stuff. I am upping my Vitamin D + K in the meantime too. Let's see! Thanks!

Regards,
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Re: Synovitis and Arthrofibrosis: Post-Op Internal Bleeding

Post by DogfacedGirl »

Hi Minister,

That's great that your bleeding is reducing, and you have things in place to look into it, thanks for letting me know :-) I'm glad that you're taking care of yourself.

All the best,

Kay


1999 Osteoarthritis both knees, chondroplasty
2004 MACI graft L knee
2005 MACI graft both knees
2007 MACI graft R knee
2007 Patella baja
2011 TKR both knees
2011 arthrofibrosis
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Re: Synovitis and Arthrofibrosis: Post-Op Internal Bleeding

Post by minister »

Update:

Last week knee was less full than previous weeks the days after aspiration. Today the aspiration was thin and yellow, with a bit of blood at the end, so basically there's no bleeding now and is only synovial fluid.

Looks like things are moving in the right direction and there's some synovial inflammation left triggering the fluid. I have to say with the swollen knee and fluid it is almost impossible to activate and awaken the quads. Hopefully they start responding better in the next weeks.
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DogfacedGirl
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Re: Synovitis and Arthrofibrosis: Post-Op Internal Bleeding

Post by DogfacedGirl »

Thanks for the update Minister, that's good news!
Kay
1999 Osteoarthritis both knees, chondroplasty
2004 MACI graft L knee
2005 MACI graft both knees
2007 MACI graft R knee
2007 Patella baja
2011 TKR both knees
2011 arthrofibrosis
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