• Benjamin B Browning, Anthony V Ventimiglia, Anant Dixit, Emmanuel Illical, William P Urban, and Julio J Jauregui.
• SUNY Downstate Medical Center, Brooklyn, NY, United States.
• Acta Orthop Traumatol Turc. 2016 Dec 1; 50 (6): 597-600.

IntroductionThe aim of this systematic review was to assess the efficacy of Saline load tests (SLTs) to evaluate extension of periarticular wounds into capsule in emergent settings.MethodsWe systematically reviewed the literature to evaluate the accuracy of the SLT in diagnosing penetrating joint injuries in the elbow, wrist, shoulder, knee, or ankle.ResultsThe SLT values to determine knee arthrotomies vary from 73.8 mL to 194 mL with sensitivities ranging between 91% and 99% depending on the size of the laceration. A SLT of 30 mL in the ankle yields sensitivities ranging from 95% to 99% in assessing joint penetration. A SLT of 45 mL in the elbow yields a sensitivity of 95% in assessing joint penetration. The addition of methylene blue does not change the sensitivity of the SLT.ConclusionSeveral studies have demonstrated the utility of the SLT as a diagnostic modality for penetrating joint injuries. However, the literature analyzed in this study was inconclusive and more studies are required to make definitive recommendations. In addition, more studies will be needed on joints other than the knee, pediatric patients, and the use of methylene blue dye in conjunction with SLT.Level Of EvidenceLevel II, Diagnostic study.Copyright © 2016 Turkish Association of Orthopaedics and Traumatology. Production and hosting by Elsevier B.V. All rights reserved.

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