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Spontaneous recurrent hemarthrosis as a late complication after total knee arthroplasty is a rare occurrence. Herein we report a case of recurrent hemarthrosis 3 years after total knee arthroplasty. The first episode of hemarthrosis occurred 30 months after total knee arthfoplasty. The hemarthrosis failed to respond to conservative treatment and open synovectomy was performed one year from the onset of symptom. At surgery, hypertrophic synovial tissue with hemorrhage was noted throughout the knee joint. Microscopic findings revealed focal villous projections of the hyperplastic synovium with numerous hemosiderin filled histiocytes. Postoperatively, patient did well and no recurrent hemarthrois was noted. Based upon the experience from this case, it is our opinion that entrapment of florid synovitis causes the recurrent hemarthrosis and that synovectomy may be indicated in case of recurrent hemarthrosis after total knee arthroplasty.

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