Clinical outcomes in patients who require surgical evacuation of an acute haematoma following total knee arthroplasty

Deep haematoma formation after total knee arthroplasty can result in wound drainage, skin compromise, limited motion and pain. Haematoma formation significant enough to require early re-operation occurs in <0.5% of patients. Risk factors for development of this complication include underlying bleeding disorders in the patient, timing of tourniquet release intraoperatively and the magnitude of anticoagulation effect achieved in the post-operative period. Once this complication occurs, early surgical intervention should be considered, especially in cases where there is persistent bloody drainage or wound compromise. Long-term sequelae of this complication occur in about 15% of patients, which include the need for additional major surgery following the initial debridement and deep prosthetic infection. All efforts should be made to minimise bleeding problems and haematoma formation after total knee arthroplasty.