Glanzmann’s Thrombasthenia Diagnosed following Knee Arthroscopy

Abstract EN

A 41-year-old man with an unremarkable medical history presented with a painful knee after a sports injury.

He was diagnosed with a medial meniscal tear.

Symptoms did not abate after 6 months of physical therapy, and he underwent arthroscopic partial medial meniscectomy.

A week after beginning physical therapy he experienced a knee effusion, decreased ROM, and inability to flex his quadriceps.

His knee was aspirated.

Blood tests were ordered and his complete blood count, liver functions tests, and INR/PTT were normal.

The patient had recurrent effusions requiring three additional joint aspirations.

Ten weeks after the initial surgery, the patient underwent a second arthroscopy, during which a hematoma was removed and a synovectomy performed.

The patient continued bleeding from the incisions after portals were sutured, and he was admitted to the hospital.

A hematologist was consulted and comprehensive platelet aggregation testing revealed previously undiagnosed Glanzmann’s thrombasthenia.

The patient began treatment with platelet infusions and desmopressin and progressed to a full recovery.

Clinical suspicion for surgical patients with unusual repetitive postoperative bleeding should include previously undetected rare bleeding disorders even in adults.