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document
Detection of traumatic arthrotomy of the knee using the saline solution load test . 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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Intervention_Educational
saline solution load test
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Intervention_Educational
saline solution load test
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Intervention_Pharmacological
saline solution
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Intervention_Physical
single stab incision with use of a number-11 blade
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Intervention_Pharmacological
injection of normal saline solution at a rate of 5 mL/sec through an 18-gauge needle
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Outcome_Other
appropriate volume
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Outcome_Other
needle location
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Outcome_Physical
average body mass index
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Outcome_Other
diagnose 50 % of the arthrotomies
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Outcome_Other
volumes that were needed in order to effectively diagnose
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Outcome_Physical
mean volumes of injected fluid needed for a positive result at the inferomedial and superomedial needle locations
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Outcome_Other
significantly less fluid
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Participant_Sample-size
Fifty-six
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Participant_Condition
scheduled for knee arthroscopy
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Participant_Sample-size
thirty-one
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Participant_Sex
female
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Participant_Sample-size
patients and twenty-five
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Participant_Sex
male
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Participant_Sample-size
patients
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Participant_Age
average age of fifty years