Hemathrosis treated by aspiration and casting. How to condemn the knee

Eighty-eight athletes treated for an acute hemarthrosis of the knee without any demonstrable ligament tear were evaluated. Analysis of the clinical data from these cases, all treated between 1970 and 1975 with aspiration and casting, revealed that the injury was apparently worse than had been thought at the time of first treatment. Surgery was subsequently performed in 32 (37%) because of meniscus tear, and 28 demonstrated anterior cruciate ligament insufficiency. In the 56 who did not have surgical treatment, 38 (43% of the entire group) had significant symptoms and disability causing them to decrease sports participation, and only 18 (20% of the overall group) returned to sports without symptoms or disability. Objective findings at followup suggested that in 70% of the patients injury of the anterior cruciate ligament occurred during the original trauma. A precise diagnosis is needed in every knee ligament sprain with hemarthrosis before one decides upon conservative treatment such as aspiration and casting.