Arthroscopic Evaluation of Acute Traumatic Hemarthrosis of the Knee

We studied the incidence of intraar- ticular injury in acutely injured stable knee with hemarthrosis. Our prospective study included 50 consecutive patients presenting at the Accidents and Emergency Centre, Ljubljana with acute traumatic knee hemarthrosis, stable knee joint and with no radiographic evidence of intraarticular fracture. Patients with a history of previous injuries or a diagnosis of hemorrhag­ic disorders were not included in the study. Intraarticular injuries were evaluated arthroscopically. In 48 patients, 100 lesions to intraar­ticular structures were found; 2 arthroscopies were negative. There were 18 cases of isolat­ed injuries (36%). Anterior cruciate ligaments were affected in 62% of cases, and the medial meniscus in 48%. Sixteen patients (32%) had either isolated or concomitant osteochondral lesions. Our results indicate that the presence of intraarticular blood in an acutely injured knee is compatible with a clinically relevant intraar­ticular damage. Accurate evaluation is a pre­requisite of successful treatment, the most pre­cise diagnostic tools being arthroscopy and magnetic resonance imaging. The advantage of arthroscopic assessment is that it allows for a simultaneous operative treatment, when nec­essary.