Why the study?
Does arthrocentesis of the knee cause significant hemarthrosis in patients taking oral anticoagulants with an INR ≤ 5?
Does arthrocentesis of the knee cause significant hemarthrosis in patients taking oral anticoagulants with an INR ≤ 5?
Arthrocentesis in patients on oral anticoagulants with an INR ≤ 5 appears to have a low risk of severe bleeding, suggesting it is not an absolute contraindication.
May support low severe bleeding risk for knee arthrocentesis at INR ≤5; hypothesis-generating, should not yet change practice.
OBJECTIVE: To evaluate the potential bleeding risks of arthrocentesis in patients with different arthropathies and taking oral anticoagulants. MATERIALS AND METHODS: Fifteen consecutive patients, 8 males and 7 females, treated with anticoagulant therapy for atrial fibrillation (9 pts), deep venous thrombosis (4 pts) and replacement of cardiac valves (3 pts) were submitted to arthrocentesis for synovial fluid effusion due to different arthropathies. In all patients INR was </= 5. Nine of them were assuming AINS for the joint pain. RESULTS: Two of fifteen patients have hemarthrosis, the first only lightly, the second more frankly. Both the patients were in therapy with AINS and INR was 3.8 and 5, respectively. CONCLUSIONS: The hemarthrosis or bleeding frequency associated with intraarticular injections in patients taking anticoagulant therapy seems not very high. Therefore the therapy with oral anticoagulants would not be an absolute contraindication to the arthrocentesis execution.
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Salvati et al. (2011) studied this question.
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