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SIR 2026

Traditional Poster

Embolization

Session: Traditional Poster Presentations

520 - Safety and Efficacy of Selective Arterial Embolization for Recurrent Hemarthrosis After Total Knee Arthroplasty: A Systematic Review and Meta-Analysis

Monday, April 13, 2026
12:10 PM - 1:10 PM ET
Purpose: The aim of this study was to assess the available evidence on the efficacy and safety of selective arterial embolization (SAE) as a minimally invasive treatment for recurrent hemarthrosis (RH) following total knee arthroplasty (TKA) through a systematic review and meta-analysis.

Materials and Methods: A systematic search was conducted through PubMed, Embase, Google Scholar, Cochrane (CENTRAL), Scopus, and ClinicalTrials.gov using keywords to identify relevant studies. Case reports, commentaries, non-human research, duplicates, and studies lacking data on SAE for RH were excluded. Eligible studies included retrospective cohorts and case series reporting relevant clinical outcomes. Risk of bias was assessed using the ROBINS-I tool. The primary outcome was clinical success, defined as resolution or significant improvement of RH. Secondary outcomes included recurrence rate, number of vessels embolized, and complication rates (major and minor). A random-effects model was used to pool event data and calculate proportions with 95% confidence intervals (CIs). Heterogeneity was assessed using the I² statistic. Publication bias was evaluated using funnel plot analysis and Egger’s test. All analyses were performed in R version 4.4.2, with statistical significance set at 0.05. This review was done in accordance with PRISMA guidelines{1}.

Results: Fifteen studies involving 303 participants were included. The pooled clinical success rate for SAE was 0.76 (95% CI: 0.66–0.83), while the pooled hemarthrosis recurrence rate was 0.25 (95% CI: 0.19–0.30). Across six studies, the mean number of vessels embolized was 2.77 (95% CI, 2.28–3.26), with significant heterogeneity. The pooled major complication rate was 0.08 (95% CI, 0.04–0.14), and the pooled minor complication rate was 0.12 (95% CI, 0.07–0.19). Funnel plot asymmetry and Egger’s test indicated the presence of publication bias.

Conclusion: SAE appears to be a safe and effective minimally invasive option for managing RH after TKA, with high clinical success and acceptable complication rates. However, the observed recurrence rate, heterogeneity among studies, and evidence of publication bias highlight the need for larger, prospective trials to better define the long-term efficacy and safety of SAE in this setting.