Document Detail


Detection of traumatic arthrotomy of the knee using the saline solution load test.
MedLine Citation:
PMID:  19122080     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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: Fifty-six 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 thirty-one female patients and twenty-five male patients with a combined average age of fifty 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.
Authors:
Russell M Nord; Tony Quach; Michael Walsh; David Pereira; Nirmal C Tejwani
Publication Detail:
Type:  Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  The Journal of bone and joint surgery. American volume     Volume:  91     ISSN:  1535-1386     ISO Abbreviation:  J Bone Joint Surg Am     Publication Date:  2009 Jan 
Date Detail:
Created Date:  2009-01-05     Completed Date:  2009-02-10     Revised Date:  2010-10-25    
Medline Journal Info:
Nlm Unique ID:  0014030     Medline TA:  J Bone Joint Surg Am     Country:  United States    
Other Details:
Languages:  eng     Pagination:  66-70     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Arthroscopy / methods*
Female
Humans
Injections, Intra-Articular
Knee Injuries / diagnosis*,  surgery
Knee Joint / surgery*
Male
Middle Aged
Sodium Chloride / administration & dosage,  diagnostic use*
Treatment Outcome
Chemical
Reg. No./Substance:
7647-14-5/Sodium Chloride

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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