Knee Joint Injection: Difference between revisions
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{{procedure | {{procedure | ||
|indication= | |indication= | ||
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|needle= | |needle= | ||
|steroid= | |steroid= | ||
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|local= | |local= | ||
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==Contraindications== | ==Contraindications== | ||
Infection, uncontrolled coagulopathy, joint prosthesis, poor response to previous injections. Allergy to eggs or feathers is a relative contraindication to hyaluronic acid. | |||
==Pre-procedural Evaluation== | ==Pre-procedural Evaluation== | ||
==Injectate== | |||
A variety of options exist for injectates - steroid, visco-supplementation, [[Platelet Rich Plasma Injection|platelet rich plasma]], stem cells, and dextrose prolotherapy. | |||
==Equipment== | ==Equipment== | ||
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===Landmark Guided=== | ===Landmark Guided=== | ||
*Protective gloves and use sterile technique. | |||
*Position: Lie supine with the knee slightly flexed, supported underneath with a rolled towel or cushion. | |||
*Palpate and identify the borders of the patella and mark the entry site | |||
*Clean the skin | |||
*Draw up the injectate mixture. | |||
* | |||
Use a combination of 5 to 10 ml of 1% lidocaine or 0.25% to 0.5% bupivacaine mixed with 0.5 to 2 ml of the selected steroid (20-80 mg of methylprednisolone acetate, 20-40 mg of triamcinolone acetate or 6-12 mg of betamethasone acetate/phosphate). | |||
Hyaluronic acid injections come in 2 ml prefilled syringes given once per week for 5 weeks for Hyalgan and once per week for 3 weeks for Synvisc. | |||
==Complications== | ==Complications== | ||
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{{Reliable sources|synonym1=""|synonym2=""|synonym3=""}} | {{Reliable sources|synonym1=""|synonym2=""|synonym3=""}} | ||
[[Category:Infoboxes]] | |||
[[Category:Knee & Leg Procedures]] | [[Category:Knee & Leg Procedures]] | ||
Revision as of 14:20, 2 April 2021
| Knee Joint Injection | |
|---|---|
| Indication | |
Anatomy
Indications
Contraindications
Infection, uncontrolled coagulopathy, joint prosthesis, poor response to previous injections. Allergy to eggs or feathers is a relative contraindication to hyaluronic acid.
Pre-procedural Evaluation
Injectate
A variety of options exist for injectates - steroid, visco-supplementation, platelet rich plasma, stem cells, and dextrose prolotherapy.
Equipment
Technique
Ultrasound Guided
Fluoroscopy Guided
Landmark Guided
- Protective gloves and use sterile technique.
- Position: Lie supine with the knee slightly flexed, supported underneath with a rolled towel or cushion.
- Palpate and identify the borders of the patella and mark the entry site
- Clean the skin
- Draw up the injectate mixture.
Use a combination of 5 to 10 ml of 1% lidocaine or 0.25% to 0.5% bupivacaine mixed with 0.5 to 2 ml of the selected steroid (20-80 mg of methylprednisolone acetate, 20-40 mg of triamcinolone acetate or 6-12 mg of betamethasone acetate/phosphate). Hyaluronic acid injections come in 2 ml prefilled syringes given once per week for 5 weeks for Hyalgan and once per week for 3 weeks for Synvisc.
Complications
Repetitive intra-articular corticosteroid injections may cause accelerated cartilage loss. McAlindon evaluated triamcinolone vs saline repeated every 12 weeks for 2 years in 141 patients with knee osteoarthritis. The steroid group had greater cartilage loss (-0.21 mm vs -0.10mm), and no significant difference in pain. There was a small increase in HbA1c levels in the steroid group. The steroid group had 5 complications, and the saline group had 3.[1]
Aftercare
Videos
See Also
External Links
References
Literature Review
Literature Review
- Reviews from the last 7 years: review articles, free review articles, systematic reviews, meta-analyses, NCBI Bookshelf
- Articles from all years: PubMed search, Google Scholar search.
- TRIP Database: clinical publications about evidence-based medicine.
- Other Wikis: Radiopaedia, Wikipedia Search, Wikipedia I Feel Lucky, Orthobullets,
