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Does the Saline Load Test Still Have a Role in the Orthopaedic World? A systematic review of the literature.

, - , 03.06.2016

Abstract

Introduction: Periarticular injuries are important to evaluate as joint penetration may result in septic arthritis. Although the gold-standard to evaluate the integrity of the joint capsule is surgical exploration, this requires extensive operative resources and is costly. Saline Load Tests (SLTs) have consequently been used in emergent settings to evaluate extension of periarticular wounds into capsule. Since no study has comprehensively evaluated the ability of SLT to detect open wound injuries within different joints, we systematically evaluated all literature.

Methods: We systematically evaluated the accuracy of the SLT in diagnosing penetrating joint injuries in the elbow, wrist, shoulder, knee, or ankle utilizing specific inclusion/exclusion criteria.  

Results: The SLT values to determine knee arthrotomies vary from 73.8 mL to 194 mL with sensitivities ranging from 91%-99% depending on the size of the laceration. A SLT of 30 mLs in the ankle yields sensitivities ranging from 95-99% in assessing joint penetration. A SLT of 45 mL in the elbow yields a sensitivity of 95% in assessing joint penetration. The addition of methylene blue does not change the sensitivity of the SLT.

Conclusion: Penetrating joint injuries require prompt diagnosis to avoid deleterious sequelae.  Several groups have demonstrated the utility of the SLT as a diagnostic modality for such injuries.  However, the literature analyzed in this study was inconclusive and more studies are required to make definitive recommendations. In addition, more studies will be needed on joints other than the knee, pediatric patients, and the use of methylene blue dye in conjunction with SLT.

 

DOI: 10.3944/AOTT.2016.15.0398
This abstract belongs to the un-edited version of the article and is only for informative purposes. Published version may differ from the current version.

, - , 03.06.2016

Abstract

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Details

Primary Language English
Journal Section Original Article
Authors

Benjamin Browning This is me

Anthony Ventimiglia This is me

Anant Dixit This is me

Emmanuel Illical This is me

William Urban This is me

Julio Jauregui

Publication Date June 3, 2016
Published in Issue

Cite

APA Browning, B., Ventimiglia, A., Dixit, A., Illical, E., et al. (2016). Does the Saline Load Test Still Have a Role in the Orthopaedic World? A systematic review of the literature. Acta Orthopaedica Et Traumatologica Turcica.
AMA Browning B, Ventimiglia A, Dixit A, Illical E, Urban W, Jauregui J. Does the Saline Load Test Still Have a Role in the Orthopaedic World? A systematic review of the literature. Acta Orthopaedica et Traumatologica Turcica. Published online June 1, 2016.
Chicago Browning, Benjamin, Anthony Ventimiglia, Anant Dixit, Emmanuel Illical, William Urban, and Julio Jauregui. “Does the Saline Load Test Still Have a Role in the Orthopaedic World? A Systematic Review of the Literature”. Acta Orthopaedica Et Traumatologica Turcica, June (June 2016).
EndNote Browning B, Ventimiglia A, Dixit A, Illical E, Urban W, Jauregui J (June 1, 2016) Does the Saline Load Test Still Have a Role in the Orthopaedic World? A systematic review of the literature. Acta Orthopaedica et Traumatologica Turcica
IEEE B. Browning, A. Ventimiglia, A. Dixit, E. Illical, W. Urban, and J. Jauregui, “Does the Saline Load Test Still Have a Role in the Orthopaedic World? A systematic review of the literature”., Acta Orthopaedica et Traumatologica Turcica, June 2016.
ISNAD Browning, Benjamin et al. “Does the Saline Load Test Still Have a Role in the Orthopaedic World? A Systematic Review of the Literature”. Acta Orthopaedica et Traumatologica Turcica. June 2016.
JAMA Browning B, Ventimiglia A, Dixit A, Illical E, Urban W, Jauregui J. Does the Saline Load Test Still Have a Role in the Orthopaedic World? A systematic review of the literature. Acta Orthopaedica et Traumatologica Turcica. 2016.
MLA Browning, Benjamin et al. “Does the Saline Load Test Still Have a Role in the Orthopaedic World? A Systematic Review of the Literature”. Acta Orthopaedica Et Traumatologica Turcica, 2016.
Vancouver Browning B, Ventimiglia A, Dixit A, Illical E, Urban W, Jauregui J. Does the Saline Load Test Still Have a Role in the Orthopaedic World? A systematic review of the literature. Acta Orthopaedica et Traumatologica Turcica. 2016.