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A novel infrapatellar approach of ultrasound-guided intra-articular injection of the knee from both lateral and medial side: a case series

Knee osteoarthritis (OA) is common. Ultrasound-guided intra-articular injection (UGIAI) using the superolateral approach is currently the gold standard for treating knee OA, but it is not 100% accurate, especially in patients with no knee effusion. Herein, we present a case series of chronic knee OA...

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Autores principales: Lam, King Hei Stanley, Wu, Yung-Tsan, Reeves, Kenneth Dean, Hadzic, Admir, Perez, Mario Fajardo, Fu, Sau Nga
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9923012/
https://www.ncbi.nlm.nih.gov/pubmed/36793993
http://dx.doi.org/10.1177/1759720X221149954
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author Lam, King Hei Stanley
Wu, Yung-Tsan
Reeves, Kenneth Dean
Hadzic, Admir
Perez, Mario Fajardo
Fu, Sau Nga
author_facet Lam, King Hei Stanley
Wu, Yung-Tsan
Reeves, Kenneth Dean
Hadzic, Admir
Perez, Mario Fajardo
Fu, Sau Nga
author_sort Lam, King Hei Stanley
collection PubMed
description Knee osteoarthritis (OA) is common. Ultrasound-guided intra-articular injection (UGIAI) using the superolateral approach is currently the gold standard for treating knee OA, but it is not 100% accurate, especially in patients with no knee effusion. Herein, we present a case series of chronic knee OA treated with a novel infrapatellar approach to UGIAI. Five patients with chronic grade 2–3 knee OA, who had failed on conservative treatments and had no effusion but presented with osteochondral lesions over the femoral condyle, were treated with UGIAI with different injectates using the novel infrapatellar approach. The first patient was initially treated using the traditional superolateral approach, but the injectate was not delivered intra-articularly and became trapped in the pre-femoral fat pad. The trapped injectate was aspirated in the same session due to interference with knee extension, and the injection was repeated using the novel infrapatellar approach. All patients who received the UGIAI using the infrapatellar approach had the injectates successfully delivered intra-articularly, as confirmed with dynamic ultrasound scanning. Their Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain, stiffness, and function scores significantly improved 1 and 4 weeks post-injection. UGIAI of the knee using a novel infrapatellar approach is readily learned and may improve accuracy of UGIAI, even for patients with no effusion.
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spelling pubmed-99230122023-02-14 A novel infrapatellar approach of ultrasound-guided intra-articular injection of the knee from both lateral and medial side: a case series Lam, King Hei Stanley Wu, Yung-Tsan Reeves, Kenneth Dean Hadzic, Admir Perez, Mario Fajardo Fu, Sau Nga Ther Adv Musculoskelet Dis Case Series Knee osteoarthritis (OA) is common. Ultrasound-guided intra-articular injection (UGIAI) using the superolateral approach is currently the gold standard for treating knee OA, but it is not 100% accurate, especially in patients with no knee effusion. Herein, we present a case series of chronic knee OA treated with a novel infrapatellar approach to UGIAI. Five patients with chronic grade 2–3 knee OA, who had failed on conservative treatments and had no effusion but presented with osteochondral lesions over the femoral condyle, were treated with UGIAI with different injectates using the novel infrapatellar approach. The first patient was initially treated using the traditional superolateral approach, but the injectate was not delivered intra-articularly and became trapped in the pre-femoral fat pad. The trapped injectate was aspirated in the same session due to interference with knee extension, and the injection was repeated using the novel infrapatellar approach. All patients who received the UGIAI using the infrapatellar approach had the injectates successfully delivered intra-articularly, as confirmed with dynamic ultrasound scanning. Their Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain, stiffness, and function scores significantly improved 1 and 4 weeks post-injection. UGIAI of the knee using a novel infrapatellar approach is readily learned and may improve accuracy of UGIAI, even for patients with no effusion. SAGE Publications 2023-01-31 /pmc/articles/PMC9923012/ /pubmed/36793993 http://dx.doi.org/10.1177/1759720X221149954 Text en © The Author(s), 2023 https://creativecommons.org/licenses/by-nc/4.0/This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Case Series
Lam, King Hei Stanley
Wu, Yung-Tsan
Reeves, Kenneth Dean
Hadzic, Admir
Perez, Mario Fajardo
Fu, Sau Nga
A novel infrapatellar approach of ultrasound-guided intra-articular injection of the knee from both lateral and medial side: a case series
title A novel infrapatellar approach of ultrasound-guided intra-articular injection of the knee from both lateral and medial side: a case series
title_full A novel infrapatellar approach of ultrasound-guided intra-articular injection of the knee from both lateral and medial side: a case series
title_fullStr A novel infrapatellar approach of ultrasound-guided intra-articular injection of the knee from both lateral and medial side: a case series
title_full_unstemmed A novel infrapatellar approach of ultrasound-guided intra-articular injection of the knee from both lateral and medial side: a case series
title_short A novel infrapatellar approach of ultrasound-guided intra-articular injection of the knee from both lateral and medial side: a case series
title_sort novel infrapatellar approach of ultrasound-guided intra-articular injection of the knee from both lateral and medial side: a case series
topic Case Series
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9923012/
https://www.ncbi.nlm.nih.gov/pubmed/36793993
http://dx.doi.org/10.1177/1759720X221149954
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