The saline load test (SLT)

There are currently two different strategies for diagnosing traumatic arthrotomy
with peri-articualar wounds. The most common nonsurgical diagnostic tool is the saline
load test (SLT). It is performed by injecting sterile saline into the joint an area away from
the open wound. Extravasation of fluid from the would is indicative of traumatic
arthrotomy.2 A negative SLT test would be the circumstance in which sterile saline is
injected into the joint capsule to the desired amount and there is no extravasation of fluid.
This indicates that the joint capsule is still intact and the trauma does not penetrate into
the joint. The second diagnostic approach is where the provider conducts a thorough
wound inspection is performed to search for a traumatic arthrotomy. If traumatic
arthrotomy is then suspected an orthopedic surgeon performs an intraoperative inspection
of the joint capsule.
Although the SLT is a widely accepted as the test of choice to diagnose traumatic
arthrotomy of the knee and other joints, there is a lack of clinical evidence to support this
as a diagnostic tool. This systematic review will specifically address using SLT as a
diagnostic tool for identifying traumatic arthrotomy for and attempt to pinpoint at what
volumes provide the highest specificity and sensitivity.