Harilainen A, Myllynen P, Antila H, Seitsalo S
Department of Orthopaedics and Traumatology, Helsinki University Central Hospital, Finland.
Injury. 1988 Jan;19(1):21-4. doi: 10.1016/0020-1383(88)90168-4.
Arthroscopy and examination under anaesthesia were performed for 328 consecutive knee injuries with haemarthrosis. These examinations were grouped according to a modified classification (Jackson and Abe, 1972) into very useful (117/328, 36 per cent), useful (98/328, 30 per cent) and useless (113/328, 34 per cent) categories. The probability of arthroscopy being useful was estimated mathematically. The factors which made this procedure useful were knee pain on exertion before the injury (P = 0.0561), the mechanism of the injury (P less than 0.0001) and the clinical stability of the patella (P = 0.0007). On arrival in the emergency department it was first decided whether the leg should be mobilized, immobilized in a plaster cast, operated on or, if a definitive diagnosis could not be reached, arthroscopy was deemed necessary. This resulted in the treatment following arthroscopy, and examination under anaesthesia, being altered from conservative to operative (P less than 0.0001). Results suggest that arthroscopy and examination under anaesthesia should always be considered to help in the diagnosis of acute injury haemarthrosis of the knee especially after a valgus or varus strain.
对连续328例因膝关节积血而受伤的患者进行了关节镜检查和麻醉下检查。这些检查根据改良分类法（Jackson和Abe，1972年）分为非常有用（117/328，36%）、有用（98/328，30%）和无用（113/328，34%）三类。通过数学方法估算了关节镜检查有用的概率。使该检查有用的因素包括受伤前用力时的膝关节疼痛（P = 0.0561）、损伤机制（P < 0.0001）和髌骨的临床稳定性（P = 0.0007）。在患者到达急诊科时，首先要决定是让腿部活动、用石膏固定、进行手术，还是在无法做出明确诊断时认为有必要进行关节镜检查。这导致关节镜检查和麻醉下检查后的治疗从保守治疗改为手术治疗（P < 0.0001）。结果表明，对于膝关节急性损伤积血的诊断，尤其是在膝外翻或膝内翻损伤后，应始终考虑进行关节镜检查和麻醉下检查。
