A short cut review was carried out to establish whether aspiration of a traumatic knee haemarthrosis improved the patient's symptoms. Altogether 267 papers were found using the reported search, of which none answered the question posed. Further research is needed in this area.
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Report by Paul Wallman, Senior Clinical Fellow Checked by Simon Carley, Specialist Registrar
A 40 year old man presents to the emergency department one day after suffering an injury to his knee. There is no evidence of bony injury on radiography and a diagnosis of a traumatic haemarthrosis is made. You are unsure whether aspiration of the tense haemarthrosis will benefit him symptomatically.
Three part question
In [patients with an acute traumatic haemarthrosis of the knee] does [aspiration] [improve symptoms]?
Medline 1966–10/01 using the OVID interface. (exp knee OR exp knee injuries OR exp knee joint OR exp medial collateral ligament, knee OR knee.mp) AND (exp hemarthrosis OR haemarthrosis.mp OR hemarthrosis.mp OR effusion.mp OR exp synovial fluid OR synovial fluid.mp) AND (exp aspiration OR aspiration.mp. OR aspirate$.mp OR exp drainage OR drain.mp OR drains.mp OR exp emergency treatment OR exp treatment failure OR exp treatment outcome OR treatment.mp. OR treat$.mp) AND maximally sensitive RCT filter LIMIT to human AND English.
Altogether 267 papers found of which none were relevant to the original question.
Despite the fact that many clinicians hold firm views about this matter, there is no published evidence to inform a decision.
CLINICAL BOTTOM LINE
Local advice should be followed.
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