From 2007 to 2009, three studies were published that challenged the sensitivity of a low-volume (50 cc to 60 cc) SLT to accurately diagnose small traumatic arthrotomies. Keese and coworkers injected the knees of 30 patients undergoing elective knee arthroscopy with a 50 cc SLT after creating a small arthrotomy (26.4 [mm.sup.2]) and found that 194 cc of saline was necessary to achieve 95% sensitivity.
In summary, the evidence-to-date indicates that the SLT is inadequate to diagnose traumatic arthrotomies (Table 3).
Konda and coworkers were the first to describe the use computed tomography scan (CT scan) to routinely diagnose traumatic arthrotomies. (6) Based on the assumption that traumatic knee arthrotomies result in intra-articular air that is readily visible on CT scans (Fig.
The sensitivity and specificity of the CT scan to detect traumatic arthrotomies and rule-out periarticular wounds equivalent to no traumatic arthrotomy was 100%.
The saline load test of the knee redefined: a test to detect traumatic arthrotomies and rule out periarticular wounds not requiring surgical intervention.
Computed tomography scan to detect traumatic arthrotomies and identify periarticular wounds not requiring surgical intervention: an improvement over the saline load test.