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Aspiration brings short-term benefits for patients with knee effusion with a traumatic etiology
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CHICAGO — Investigators of a level 1 study discovered that intra-articular aspiration provided temporary improvement in patients with knee effusion, particularly in those with a history of trauma, but the results soon deteriorated.
“Aspiration results in better outcomes short-term,” Nikolaos K. Paschos, MD, of Davis, Calif., said during his presentation at the American Academy of Orthopaedic Surgeons Annual Meeting. “After the initial improvement in traumatic effusions, you may expect edema accumulation that deteriorates outcome.”
He added, “Knee aspiration has a role in defining the diagnosis in cases that we do not know.”
Nikolaos K. Paschos
Paschos and colleagues conducted a prospective, randomized controlled trial of 213 patients with moderate to severe edema who were followed up for 1 year. They excluded patients with bilateral edema, with known conditions that could be related to knee effusion or who had received prior treatment for the condition. The aspiration group included 106 patients. Of these, 52 patients had a history of trauma. In the nonaspirated group, 56 patients of the 107 patients had a history of trauma, based on study results.
The investigators measured range of motion, pain relief, edema, Knee Society Scores and outcomes using the KOOS and Visual Analog Scale for pain.
“We found that aspiration did indeed help with the outcome in pain, edema and range of motion, but this result only lasted for 1 week. After that period of time, there was no difference between the two groups.”
The short-term benefit of aspiration was especially noted when the researchers performed a subanalysis of patients with a history of trauma compared to non-traumatic patients.
“While the patients in the first week with trauma had a fair outcome; after the first week, they had a worse outcome,” Paschos said. “On the contrary, aspiration of non-traumatic effusion resulted in worse outcome,” he and colleagues wrote in their abstract.
Paschos also noted that patients in the aspiration group had an earlier diagnosis of knee effusion, pointing to the potential usefulness of aspiration to establish diagnosis.
In addition, he said, “One disadvantage that we noticed, specifically in large traumatic effusions, was the fact that the edema was accumulating fast. We had a patient who developed signs of infection related to aspiration.”
Reference:
Paschos NK. Paper #12. Presented at: American Academy of Orthopaedic Surgeons Annual Meeting; March 19-23, 2013; Chicago.
Disclosure: Paschos has no relevant financial disclosures.