| Detection of traumatic arthrotomy of the knee using the saline solution load test. | |
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MedLine Citation:
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PMID: 19122080 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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: 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. |
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Authors:
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Russell M Nord; Tony Quach; Michael Walsh; David Pereira; Nirmal C Tejwani |
Publication Detail:
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Type: Journal Article; Randomized Controlled Trial |
Journal Detail:
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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:
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Created Date: 2009-01-05 Completed Date: 2009-02-10 Revised Date: 2010-10-25 |
Medline Journal Info:
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Nlm Unique ID: 0014030 Medline TA: J Bone Joint Surg Am Country: United States |
Other Details:
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Languages: eng Pagination: 66-70 Citation Subset: AIM; IM |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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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:
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7647-14-5/Sodium Chloride |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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