Nord, J Bone Joint Surg Am 2009 - Detection of Traumatic Arthrotomy of the Knee Using the Saline Solution Load Test

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Detection of Traumatic Arthrotomy of the Knee Using the Saline Solution Load Test

Nord, Tejwani, et al.·J Bone Joint Surg Am·2009·52 citations·Prospective cohort

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Background

The saline solution load test helps to determine if a wound extends into the knee joint. Little is known about the volume of injected intra-articular saline solution that is needed to effectively rule in or rule out a traumatic arthrotomy of the knee. The purpose of the present study was to determine the appropriate volume and needle location for the diagnosis of a traumatic knee arthrotomy and to assess the effect of associated variables, including knee circumference, body mass index, and sex.

Methods

56 consecutive patients scheduled for knee arthroscopy were enrolled.
A standard inferolateral arthroscopic portal was made with a single stab incision with use of a number-11 blade.
Injection sites were randomized to either a superomedial or inferomedial location.
The injection of normal saline solution at a rate of 5 mL/sec through an 18-gauge needle was continued while the knee was moved through a range of motion until fluid extravasated from the iatrogenic laceration.
The volume of injected fluid was recorded.

Results

The study group included 31 female patients and 25 male patients with a combined average age of 50 years and an average body mass index of 30.9.
In order to effectively diagnose 50% of the arthrotomies, 75 mL of injected fluid was needed; the volumes that were needed in order to effectively diagnose 75%, 90%, 95%, and 99% of the arthrotomies were 110, 145, 155, and 175 mL, respectively.
The mean volumes of injected fluid needed for a positive result at the inferomedial and superomedial needle locations were 64.0 and 95.2 mL, respectively; this difference was significant (p = 0.01).
There was no correlation between necessary injection volume and sex, body mass index, or knee circumference.

Conclusions

In order to detect 95% of 1-cm inferolateral arthrotomies of the knee with use of the saline solution load test, 155 mL must be injected. An inferomedial injection location requires significantly less fluid than a superomedial injection location does for the diagnosis of inferolateral arthrotomies of the knee.

Copyright remains with the authors and publisher.

Detection of Traumatic Arthrotomy of the Knee Using the Saline Solution Load Test.

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Detection of Traumatic Arthrotomy of the Knee Using the Saline Solution Load Test

Nord, Tejwani, et al.·J Bone Joint Surg Am·2009·52 citations·Prospective cohort

|

Background

The saline solution load test helps to determine if a wound extends into the knee joint. Little is known about the volume of injected intra-articular saline solution that is needed to effectively rule in or rule out a traumatic arthrotomy of the knee. The purpose of the present study was to determine the appropriate volume and needle location for the diagnosis of a traumatic knee arthrotomy and to assess the effect of associated variables, including knee circumference, body mass index, and sex.

Methods

56 consecutive patients scheduled for knee arthroscopy were enrolled.
A standard inferolateral arthroscopic portal was made with a single stab incision with use of a number-11 blade.
Injection sites were randomized to either a superomedial or inferomedial location.
The injection of normal saline solution at a rate of 5 mL/sec through an 18-gauge needle was continued while the knee was moved through a range of motion until fluid extravasated from the iatrogenic laceration.
The volume of injected fluid was recorded.

Results

The study group included 31 female patients and 25 male patients with a combined average age of 50 years and an average body mass index of 30.9.
In order to effectively diagnose 50% of the arthrotomies, 75 mL of injected fluid was needed; the volumes that were needed in order to effectively diagnose 75%, 90%, 95%, and 99% of the arthrotomies were 110, 145, 155, and 175 mL, respectively.
The mean volumes of injected fluid needed for a positive result at the inferomedial and superomedial needle locations were 64.0 and 95.2 mL, respectively; this difference was significant (p = 0.01).
There was no correlation between necessary injection volume and sex, body mass index, or knee circumference.

Conclusions

In order to detect 95% of 1-cm inferolateral arthrotomies of the knee with use of the saline solution load test, 155 mL must be injected. An inferomedial injection location requires significantly less fluid than a superomedial injection location does for the diagnosis of inferolateral arthrotomies of the knee.

Copyright remains with the authors and publisher.

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