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Long-term prognosis of nonoperatively treated acute knee distortions having primary hemarthrosis without clinical instability

Department of Surgery, Tampere University Central Hospital, Tampere Research Station of Sports Medicine, Jyväskylä Research Unit for Sports and Physical Fitness, Tampere, and Jyväskylä, Finland

Markku Järvinen, MD

Tampere Research Station of Sports Medicine, Jyväskylä Research Unit for Sports and Physical Fitness, Tampere, and Jyväskylä, Finland

The purpose of the study was to examine the long- term prognosis of nonoperatively treated acute knee distortions having primary hemarthrosis without clinical instability. A multidimensional follow-up analysis was performed on 84 patients an average 8 years after injury. The analysis included four standardized knee scoring scales for subjective, objective, functional, and radiological evaluations, as well as isokinetic and iso metric strength measurements.

In the great majority of the patients (86%) the long- term results were excellent or good. The main reason for failure was ACL insufficiency, an obvious outcome of overlooked rupture of that ligament in the primary situation.

If the injured knee is indeed stable, if there is no suspicion of ACL injury or patella luxation in the pa tient's history or clinical findings, and if routine radio graphs are negative, primary arthroscopy is not needed. However, a close followup with repeated clin ical examinations and a well-planned rehabilitation pro gram is obligatory.