Posttraumatic hemarthrosis in view of the inflammation theory

Abstract

Introduction Post-traumatic hemarthrosis is identified as intra-articular hemorrhage accompanied by five classic signs of inflammation: hyperemia, hyperthermia, edema, pain and changes in the joint function. The objective of the study was to establish whether inflammation should be underestimated in post-traumatic hemarthrosis based on the analysis of the world scientific literature of recent years. Material and methods Internet search platform Web of Science (Clarivate Analytics, USA): databases Web of Science Core Collection (subscription access), Publons (open access), Medline (open access) were used to review scientific articles. Papers from the Scopus Elsevier database (Netherlands) were explored. The search depth was 15 years. Topics that did not receive coverage in the literature of this period were studied until the 1960s in some cases. More than 200 sources were identified on the subject. The literature published in the current year was analyzed covering 15.0 % of the materials, brought out in the last 5 years including the current year covering 56.3 %, in the last 10 years including the current year covering 73.8 %, in the last 15 years including the current year covering 81.3 %. Results and discussion The severity of injury and the accompanying inflammatory factors would characterize a rapid resolution or a more severe course of post-traumatic hemarthrosis during treatment. The combination of several variants of inflammation can lead to the development of complications including osteoarthritis in cases that show mechanisms of chronic systemic inflammation of low intensity being manifested at the time of injury; ankylosis of the joint resulting from chronic systemic inflammation of low intensity involving degenerative processes. Synovitis, as a complication of post-traumatic hemarthrosis, should be differentiated with signs of low-grade inflammation, chronic course of classical inflammation and presystemic inflammation (purulent arthritis) in view of the inflammation theory. Conclusion The analysis of modern literature has shown the complexity and versatility of aspects of inflammation in posttraumatic hemarthrosis. The lack of emphasis on the assessment of the inflammatory response in rehabilitation of patients with post‑traumatic hemarthrosis can result in complications causing preconditions for the development of osteoarthritis, ankylosis, synovitis.