The Journal of Bone and Joint Surgery, Vol 62, Issue 5 687-695, Copyright © 1980 by Journal of Bone and Joint Surgery, Inc

JOURNAL CONTENTS

Arthroscopy in acute traumatic hemarthrosis of the knee. Incidence of anterior cruciate tears and other injuries

FR Noyes, RW Bassett, ES Grood and DL Butler

In a prospective study, all injured knees that had traumatic hemarthrosis and absent or negligible instability on clinical examination underwent arthroscopy and examination under anesthesia. Eighty-five knees (eighty-three patients) were examined over a 125-week period. Some degree of disruption of the anterior cruciate ligament was found in sixty-one (72 per cent) of the knees (a partial tear in 28 per cent and a complete tear in 44 per cent), frequently associated with an injury of varying severity to other joint structures. These included minor ligament sprains without laxity in 41 per cent, a major associated ligament injury in 21 per cent, meniscal tears in 62 per cent (partial in 30 per cent and complete in 70 per cent), and a femoral chondral fracture or surface defect in 20 per cent. A popping sensation at injury occurred in 33 per cent of knees with a normal anterior cruciate ligament and in 36 per cent of those with a disruption. One-third of the knees had no to slight pain at the time of injury. The anterior drawer test without anesthesia was positive in only 24 per cent of the knees with a torn anterior cruciate ligament. We concluded that: (1) a traumatic hemarthrosis indicates a significant knee injury; (2) examination under anesthesia plus arthroscopy allows a more accurate diagnosis of injury to joint structures; and (3) such data are required for a rational treatment program to be outlined.
CiteULike    Connotea    Del.icio.us    Technorati    What's this?

This article has been cited by other articles:

				P. Neuman, M. Englund, I. Kostogiannis, T. Friden, H. Roos, and L. E. Dahlberg Prevalence of Tibiofemoral Osteoarthritis 15 Years After Nonoperative Treatment of Anterior Cruciate Ligament Injury: A Prospective Cohort Study Am. J. Sports Med., September 1, 2008; 36(9): 1717 - 1725. [Abstract] [Full Text] [PDF]

				J. H. Lubowitz, B. J. Bernardini, and J. B. Reid III Current Concepts Review: Comprehensive Physical Examination for Instability of the Knee Am. J. Sports Med., March 1, 2008; 36(3): 577 - 594. [Abstract] [Full Text] [PDF]

				M. Marcacci, E. Kon, M. Delcogliano, G. Filardo, M. Busacca, and S. Zaffagnini Arthroscopic Autologous Osteochondral Grafting for Cartilage Defects of the Knee: Prospective Study Results at a Minimum 7-Year Follow-up Am. J. Sports Med., December 1, 2007; 35(12): 2014 - 2021. [Abstract] [Full Text] [PDF]

				L. S. Lohmander, P. M. Englund, L. L. Dahl, and E. M. Roos The Long-term Consequence of Anterior Cruciate Ligament and Meniscus Injuries: Osteoarthritis Am. J. Sports Med., October 1, 2007; 35(10): 1756 - 1769. [Abstract] [Full Text] [PDF]

				S. K. Van de Velde, L. E. DeFrate, T. J. Gill, J. M. Moses, R. Papannagari, and G. Li The Effect of Anterior Cruciate Ligament Deficiency on the In Vivo Elongation of the Medial and Lateral Collateral Ligaments Am. J. Sports Med., February 1, 2007; 35(2): 294 - 300. [Abstract] [Full Text] [PDF]

				R. E. Glenn Jr, E. C. McCarty, H. G. Potter, S. F. Juliao, J. D. Gordon, and K. P. Spindler Comparison of Fresh Osteochondral Autografts and Allografts: A Canine Model Am. J. Sports Med., July 1, 2006; 34(7): 1084 - 1093. [Abstract] [Full Text] [PDF]

				B. D. Harman, S. H. Weeden, D. K. Lichota, and G. W. Brindley Osteochondral Autograft Transplantation in the Porcine Knee Am. J. Sports Med., June 1, 2006; 34(6): 913 - 918. [Abstract] [Full Text] [PDF]

				M. D. Maloney, J. J. Goater, R. Parsons, H. Ito, R. J. O'Keefe, P. T. Rubery, M. H. Drissi, and E. M. Schwarz Safety and Efficacy of Ultraviolet-A Light-Activated Gene Transduction for Gene Therapy of Articular Cartilage Defects J. Bone Joint Surg. Am., April 1, 2006; 88(4): 753 - 761. [Abstract] [Full Text] [PDF]

				S. Y. Lee, M. Miwa, Y. Sakai, R. Kuroda, T. Niikura, and M. Kurosaka Osteogenic potential of cells in vitro derived from haemarthrosis of the knee induced by injury to the anterior cruciate ligament J Bone Joint Surg Br, January 1, 2006; 88-B(1): 129 - 133. [Abstract] [Full Text] [PDF]

				J. W. Alford and B. J. Cole Cartilage Restoration, Part 1: Basic Science, Historical Perspective, Patient Evaluation, and Treatment Options Am. J. Sports Med., February 1, 2005; 33(2): 295 - 306. [Abstract] [Full Text] [PDF]

				W. R. Dunn, S. Lyman, A. E. Lincoln, P. J. Amoroso, T. Wickiewicz, and R. G. Marx The Effect of Anterior Cruciate Ligament Reconstruction on the Risk of Knee Reinjury Am. J. Sports Med., December 1, 2004; 32(8): 1906 - 1914. [Abstract] [Full Text] [PDF]

				F W Smith, E A Rosenlund, A K Aune, J A MacLean, and S W Hillis Subjective functional assessments and the return to competitive sport after anterior cruciate ligament reconstruction Br. J. Sports Med., June 1, 2004; 38(3): 279 - 284. [Abstract] [Full Text] [PDF]

				D R Jeffrey and I Watt Imaging hyaline cartilage Br. J. Radiol., November 1, 2003; 76(911): 777 - 787. [Full Text] [PDF]

				J. L. Jackson, P. G. O'Malley, and K. Kroenke Evaluation of Acute Knee Pain in Primary Care Ann Intern Med, October 7, 2003; 139(7): 575 - 588. [Abstract] [Full Text] [PDF]

				E. Davis Clinical examination of the knee following trauma: an evidence-based perspective Trauma, July 1, 2002; 4(3): 135 - 145. [Abstract] [PDF]

				T. Muellner, A. Knopp, T. C. Ludvigsen, and L. Engebretsen Failed Autologous Chondrocyte Implantation: Complete Atraumatic Graft Delamination after Two Years Am. J. Sports Med., July 1, 2001; 29(4): 516 - 519. [Full Text] [PDF]

				D. W. Jackson, M. J. Scheer, and T. M. Simon Cartilage Substitutes: Overview of Basic Science and Treatment Options J. Am. Acad. Ortho. Surg., January 1, 2001; 9(1): 37 - 52. [Abstract] [Full Text] [PDF]

				G. A. C. Murrell, S. Maddali, L. Horovitz, S. P. Oakley, and R. F. Warren The Effects of Time Course After Anterior Cruciate Ligament Injury in Correlation with Meniscal and Cartilage Loss Am. J. Sports Med., January 1, 2001; 29(1): 9 - 14. [Abstract] [Full Text] [PDF]

				E. M. Wojtys and L. J. Huston Longitudinal Effects of Anterior Cruciate Ligament Injury and Patellar Tendon Autograft Reconstruction on Neuromuscular Performance Am. J. Sports Med., May 1, 2000; 28(3): 336 - 344. [Abstract] [Full Text] [PDF]

				C. B. FRANK and D. W. JACKSON Current Concepts Review - The Science of Reconstruction of the Anterior Cruciate Ligament J. Bone Joint Surg. Am., October 1, 1997; 79(10): 1556 - 76. [Full Text]

				T. Adalberth, H. Roos, M. Lauren, P. Akeson, M. Sloth, K. Jonsson, A. Lindstrand, and L. S. Lohmander Magnetic Resonance Imaging, Scintigraphy, and Arthroscopic Evaluation of Traumatic Hemarthrosis of the Knee Am. J. Sports Med., March 1, 1997; 25(2): 231 - 237. [Abstract] [PDF]

				R. A. Majors and B. Woodfin Achieving Full Range Of Motion After Anterior Cruciate Ligament Reconstruction Am. J. Sports Med., June 1, 1996; 24(3): 350 - 355. [Abstract] [PDF]

				K. J. O'Shea, K. P. Murphy, R. D. Heekin, and P. J. Herzwurm The Diagnostic Accuracy of History, Physical Examination, and Radiographs in the Evaluation of Traumatic Knee Disorders Am. J. Sports Med., March 1, 1996; 24(2): 164 - 167. [Abstract] [PDF]

				H. J. Gelb, S. G. Glasgow, A. A. Sapega, and J. S. Torg Magnetic Resonance Imaging of Knee Disorders: Clinical Value and Cost-Effectiveness in a Sports Medicine Practice Am. J. Sports Med., January 1, 1996; 24(1): 99 - 103. [Abstract] [PDF]

				G. Y. F. Ng, B. W. Oakes, l. D. McLean, O. W. Deacon, and D. Lampard The Long-Term Biomechanical and Viscoelastic Performance of Repairing Anterior Cruciate Ligament after Hemitransection Injury in a Goat Model Am. J. Sports Med., January 1, 1996; 24(1): 109 - 117. [Abstract] [PDF]

				T. M. Matelic, D. D. Aronsson, D. W. Boyd JR, and R. L. LaMont Acute Hemarthrosis of the Knee in Children Am. J. Sports Med., December 1, 1995; 23(6): 668 - 671. [Abstract] [PDF]

				M. G. Ciccotti, J. Perry, and M. Pink Authors' Response Am. J. Sports Med., July 1, 1995; 23(4): 515 - 516. [PDF]

				J. B. Duncan, R. Hunter, M. Purnell, and J. Freeman Meniscal Injuries Associated With Acute Anterior Cruciate Ligament Tears in Alpine Skiers Am. J. Sports Med., March 1, 1995; 23(2): 170 - 172. [Abstract] [PDF]

				D. M. Lintner, E. Kamaric, J. B. Moseley, and P. C. Noble Partial Tears of the Anterior Cruciate Ligament: Are They Clinically Detectable? Am. J. Sports Med., January 1, 1995; 23(1): 111 - 118. [Abstract] [PDF]

				M. Brittberg, A. Lindahl, A. Nilsson, C. Ohlsson, O. Isaksson, and L. Peterson Treatment of Deep Cartilage Defects in the Knee with Autologous Chondrocyte Transplantation N. Engl. J. Med., October 6, 1994; 331(14): 889 - 895. [Abstract] [Full Text]

				D. M. Daniel, M. L. Stone, B. E. Dobson, D. C. Fithian, D. J. Rossman, and K. R. Kaufman Fate of the ACL-injured Patient: A Prospective Outcome Study Am. J. Sports Med., September 1, 1994; 22(5): 632 - 644. [Abstract] [PDF]

				R. F. LaPrade and Q. M. Burnett II Femoral Intercondylar Notch Stenosis and Correlation to Anterior Cruciate Ligament Injuries: A Prospective Study Am. J. Sports Med., March 1, 1994; 22(2): 198 - 203. [Abstract] [PDF]

				M. A. Oberlander, R. M. Shalvoy, and J. C. Hughston The accuracy of the clinical knee examination documented by arthroscopy: A prospective study Am. J. Sports Med., December 1, 1993; 21(6): 773 - 778. [Abstract] [PDF]

				W. B. Geissler and T. L. Whipple Intraarticular abnormalities in association with posterior cruciate ligament injuries Am. J. Sports Med., December 1, 1993; 21(6): 846 - 849. [Abstract] [PDF]

				S. A. Wasilewski, D. J. Covall, and S. Cohen Effect of surgical timing on recovery and associated injuries after anterior cruciate ligament reconstruction Am. J. Sports Med., June 1, 1993; 21(3): 338 - 342. [Abstract] [PDF]

				W. A. Grana Dear Editor Am. J. Sports Med., March 1, 1992; 20(2): 238 - 239. [PDF]

				K. D. Shelbourne and P. A. Nitz The O'Donoghue triad revisited: Combined knee injuries involving anterior cruciate and medial collateral ligament tears Am. J. Sports Med., September 1, 1991; 19(5): 474 - 477. [Abstract] [PDF]

				F. R. Noyes, E. S. Grood, J. F. Cummings, and R. R. Wroble An analysis of the pivot shift phenomenon: The knee motions and subluxations induced by different examiners Am. J. Sports Med., March 1, 1991; 19(2): 148 - 155. [Abstract] [PDF]

				A. Finsterbush, U. Frankl, Y. Matan, and G. Mann Secondary damage to the knee after isolated injury of the anterior cruciate ligament Am. J. Sports Med., September 1, 1990; 18(5): 475 - 479. [Abstract] [PDF]

				N. A. Sgaglione, R. F. Warren, T. L. Wickiewicz, D. A. Gold, and R. A. Panariello Primary repair with semitendinosus tendon augmentation of acute anterior cruciate ligament injuries Am. J. Sports Med., January 1, 1990; 18(1): 64 - 73. [Abstract] [PDF]

				K. Kimori, F. Suzu, F. Yamashita, K. Sakakida, and Y. Hirasawa Evaluation of arthrography and arthroscopy for lesions of the posteromedial corner of the knee Am. J. Sports Med., September 1, 1989; 17(5): 638 - 643. [Abstract] [PDF]

				A. F. Anderson and A. B. Lipscomb Preoperative instrumented testing of anterior and posterior knee laxity Am. J. Sports Med., June 1, 1989; 17(3): 387 - 392. [Abstract] [PDF]

				S. L. Buckley, R. L. Barrack, and A. H. Alexander The natural history of conservatively treated partial anterior cruciate ligament tears Am. J. Sports Med., March 1, 1989; 17(2): 221 - 225. [Abstract] [PDF]

				A. Finsterbush, U. Frankl, and G. Mann Fat pad adhesion to partially torn anterior cruciate ligament: A cause of knee locking Am. J. Sports Med., January 1, 1989; 17(1): 92 - 95. [Abstract] [PDF]

				F. Cerabona, M. F. Sherman, J. R. Bonamo, and J. Sklar Patterns of meniscal injury with acute anterior cruciate ligament tears Am. J. Sports Med., December 1, 1988; 16(6): 603 - 609. [Abstract] [PDF]

				R. Sandberg and B. Balkfors The durability of anterior cruciate ligament reconstruction with the patellar tendon Am. J. Sports Med., July 1, 1988; 16(4): 341 - 343. [Abstract] [PDF]

				P. J. Fowler and W. D. Regan The patient with symptomatic chronic anterior cruciate ligament insufficiency: Results of minimal arthroscopic surgery and rehabilitation Am. J. Sports Med., July 1, 1987; 15(4): 321 - 325. [Abstract] [PDF]

				P. Kannus and M. Jarvinen Long-term prognosis of nonoperatively treated acute knee distortions having primary hemarthrosis without clinical instability Am. J. Sports Med., March 1, 1987; 15(2): 138 - 143. [Abstract] [PDF]

				D. M. Daniel, M. L. Stone, R. Sachs, and L. Malcom Instrumented measurement of anterior knee laxity in patients with acute anterior cruciate ligament disruption Am. J. Sports Med., December 1, 1985; 13(6): 401 - 407. [Abstract] [PDF]

				W. J. Hopkinson, W. A. Mitchell, and W. W. Curl Chondral fractures of the knee: Cause for confusion Am. J. Sports Med., September 1, 1985; 13(5): 309 - 312. [Abstract] [PDF]

				M. Odensten, J. Lysholm, and J. Gillquist The course of partial anterior cruciate ligament ruptures Am. J. Sports Med., June 1, 1985; 13(3): 183 - 186. [Abstract] [PDF]

				J. R. Andrews, R. A. Sanders, and B. Morin Surgical treatment of anterolateral rotatory instability: A follow-up study Am. J. Sports Med., March 1, 1985; 13(2): 112 - 119. [Abstract] [PDF]

				C. E. Henning, M. A. Lynch, and K. R. Glick JR An in vivo strain gage study of elongation of the anterior cruciate ligament Am. J. Sports Med., January 1, 1985; 13(1): 22 - 26. [Abstract] [PDF]

				G. W. Woods and D. R. Chapman Repairable posterior menisco-capsular disruption in anterior cruciate ligament injuries Am. J. Sports Med., September 1, 1984; 12(5): 381 - 385. [Abstract] [PDF]

				D. A. Kieffer, R. J. Curnow, R. B. Southwell, W. F. Tucker, and K. K. Kendrick Anterior cruciate ligament arthroplasty Am. J. Sports Med., July 1, 1984; 12(4): 301 - 312. [Abstract] [PDF]

				T.D. Rosenberg and G.L. Rasmussen The function of the anterior cruciate ligament during anterior drawer and Lachman's testing: An in vivo analysis in normal knees Am. J. Sports Med., July 1, 1984; 12(4): 318 - 322. [Abstract] [PDF]

				R. S. Lucie, J. D. Wiedel, and D. G. Messner The acute pivot shift: Clinical correlation Am. J. Sports Med., June 1, 1984; 12(3): 189 - 191. [Abstract] [PDF]

				J. L. Ellera Gomes and L. R. S. Marczyk Anterior cruciate ligament reconstruction with a loop or double thickness of semitendinosus tendon Am. J. Sports Med., June 1, 1984; 12(3): 199 - 203. [Abstract] [PDF]