A Review of the Efficacy of the Saline Load Test to the Traumatic Arthrotomy of the Knee
Pinkawas Kongmalai MD*
Affiliation : * Department of Orthopaedics, Faculty of Medicine, Srinakarinwirot University, Nakhon Nayok, Thailand
Objective : Saline load test of the knee could have benefit in the evaluation of the patient with traumatic arthrotomy. The aim
of this study was to find out the efficacy in aspect of the volume to be used, the position to be done, the sensitivity and clinical
efficacy of the test.
Material and Method: The articles published after 1995 about the saline load test focusing on the knee joint which were
written in English language were reviewed. The universal database including Medline and Google Scholar were used. The
searched terms were “saline load test knee” and “saline arthrogram knee”.
Results : Ten articles were reviewed for relevancy. They consisted of four articles with level I of evidence and six articles with
level III of evidence. There were eight articles with prospective design and two articles with retrospective design. The mean
volume of the fluid was 69.8 ml. (ranged from 7.0 ml to 240 ml). The sensitivity ranged from 31% to 99%. Seven articles
suggest to use the test but two articles were opposed. One article did not give its recommendation.
Conclusion : The saline load test of the knee is a reasonable option to detect a traumatic arthrotomy of the knee. The maximum
amount of volume tolerated must be injected to gain the highest sensitivity. However, the negative test could not rule out the
potential of joint injury. There should be a discussion about the potential benefits and disadvantages with the patient and the
relatives before making a definitive treatment.
Keywords : Open knee injury, Traumatic knee arthrotomy, Saline load test, Saline arthrogram
