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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 knee.mp) AND (exp hemarthrosis OR haemarthrosis.mp OR haemarthros$.mp OR $hemarthros$.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.

Search Outcome

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

Comment(s)

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.