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Aspiration of acute traumatic knee haemarthrosis

Three Part Question

In [patients with an acute traumatic haemarthrosis of the knee] does [aspiration] [improve symptoms]?

Clinical Scenario

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 x-ray and a diagnosis of a traumatic haemarthrosis is made. You are unsure whether aspiration of the tense haemarthrosis will benefit him symptomatically.

Search Strategy

Medline 1966-11/01 using OVID interface.
[(exp knee OR exp knee injuries OR exp knee joint OR exp medial collateral ligament,knee OR AND (exp hemarthrosis OR OR haemarthros$.mp OR $hemarthros$.mp OR OR exp synovial fluid OR synovial AND (exp aspiration OR OR aspirate$.mp OR exp drainage OR OR OR exp emergency treatment OR exp treatment failure OR exp treatment outcome OR OR treat$.mp)] AND maximally sensitive RCT filter LIMIT to human AND English.

Search Outcome

267 papers found of which all were irrelevant to this particular 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.