Accuracy comparisons of intra-articular knee injection between the new modified anterolateral Approach and superolateral approach in patients with symptomatic knee osteoarthritis without effusion

C้hernchujit, Bancha; Tharakulphan, Suthee; Apivatgaroon, Adinun; Prasetia, Renaldi

doi:10.1016/j.asmart.2019.02.001

Cited by 8 publications

(20 citation statements)

References 16 publications

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“…The majority of Level I studies gathered in this review (8/12) 14-21 compared the accuracy of ultrasound-guided versus blind or landmark injection/arthrocentesis. Only 4 of 12 studies 22 , 23 , 24 , 25 compared the accuracy of anatomical-guided approaches. The majority of studies recruited patients with radiographically confirmed knee osteoarthritis (9/12 studies).…”

Section: Resultsmentioning

confidence: 99%

“…Cunnington et al 21 used an inexperienced rheumatology trainee for all ultrasound-guided injections and still had relatively high accuracy rates, 91% (32/35), compared with clinical examinationeguided IAKI performed by rheumatology consultants (median 15 years' experience), 82% (27/33). Interestingly in the anatomical accuracy comparison chart in Table 5, Chernchujit et al 24 reported that the accuracy for blind IAKI to superolateral approach only was 58% (38/66).…”

Section: Discussionmentioning

confidence: 99%

“…Wind et al 25 reported that their injection accuracy through the superomedial approach was also high at 93% (40/43). The modified anteromedial approach was used by 2 studies, Toda 25 1 e e e 1 2 e6 et al 22 and Chernchujit et al, 24 and had an accuracy rate of 86% (43/50) and 89% (59/66), respectively. In a single study looking at the superolateral approach, Chernchujit et al reported the accuracy only being 58% (38/66).…”

Section: Iaki Accuracymentioning

confidence: 99%

“…The procedural methods used in these knee injection studies also varied: 5 studies injected hyaluronic acid, 14,15,20,22 23 3 studies injected corticosteroid followed by a contrast agent, 14,17,21 and 2 studies performed arthrocentesis. 18,19 One study injected air and medical agents, 24 and 1 study injected methylene blue dye directly into the joint. 25 The differences in injected agents could lead to variability in detection, potentially confounding accuracy.…”

Section: Limitationsmentioning

confidence: 99%

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Ultrasound-Guided Knee Injections Are More Accurate Than Blind Injections: A Systematic Review of Randomized Controlled Trials

Fang

Chen

Vangsness

2021

Arthroscopy, Sports Medicine, and Rehabilitation

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Purpose: To review the current literature to determine which injection technique and needle portal placement provide the greatest accuracy for intra-articular access to the knee. Methods: This study followed Preferred Reporting Items and Systematic Reviews and Meta-Analyses guidelines. A comprehensive literature search was conducted in March 2020 and repeated in May 2020 using electronic databases PubMed, MEDLINE, and the Cochrane Library. Data on the accuracy of intra-articular knee injection (successful injections/total number of injections) were collected. Only Level I studies were included. Study design, demographic variables, needle sizes, and method of validating accuracy were recorded. The Jadad score was used to assess methodologic quality, and a risk-of-bias assessment was performed. Results: A total of 12 Level I human studies (1431 patients, 1315 knees) were included in this review. Seven of the studies did a direct comparison between ultrasound-guided and blind knee injections. Ultrasound-guided injections were more accurate compared with blinded knee injections in every study. The most accurate anatomical approach was an isometric quadricep contraction method with the superolateral approach. Conclusions: This study showed that ultrasound-guided knee injections were more accurate across every anatomical needle injection site compared with blind injections. Injections made by a blind/anatomically guided method had inconsistent accuracy rates that seemed highly dependent on the portal of entry. Level of Evidence: Level I, systematic review of Level I studies.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Iaki Accuracymentioning

confidence: 99%

Section: Limitationsmentioning

confidence: 99%

See 2 more Smart Citations

Ultrasound-Guided Knee Injections Are More Accurate Than Blind Injections: A Systematic Review of Randomized Controlled Trials

Fang

Chen

Vangsness

2021

Arthroscopy, Sports Medicine, and Rehabilitation

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“…However, in 90 o -bended knee position, a study using squishing technique [12] and post-injection mini airarthrography [13] showed higher accuracy (89%) of modi ed anterolateral approach compared to superolateral approach (58%) [14].…”

Section: Introductionmentioning

confidence: 95%

A Vibration Sensor Approach to Detect Intra-Articular Needle Tip Placement in the Knee Joint

Apinyankul¹,

Siriwattanasit²,

Srungboonmee³

et al. 2021

Preprint

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Background: Intra-articular injection in the dry knee joint is technically challenging particularly for the beginners. The aim of this study was to investigate the possible use of the vibration sensor to detect if the needle tip was at the knee intra-articular position by characterizing the frequency component of the vibration signal during empty syringe air injection.Methods: Two milliliters of air were injected supero-laterally at extra- and intra-articular positions of a cadaveric knee joint, using needles of size 18, 21 and 24 gauge. Ultrasonography was used to confirm the positions of needle tip. A piezoelectric accelerometer was mounted medially on the knee joint to collect the vibration signals which were analyzed to characterize the frequency components of the signals during injections. Results: The vibration frequency band power in the range of 500-1,500 Hertz was visually observed to potentially localize the needle tip placement during air injection whether they were at the knee extra-articular or intra-articular positions, as demonstrated by the higher band power (over -40 decibel or dB) for all the needle sizes. The differences of frequency band power between extra- and intra-articular positions were 18.1 dB, 26.4 dB and 39.2 dB for the needle size 18, 21 and 24 gauge respectively. The most obvious difference was found in the smallest needle diameter.Conclusions: A vibration sensor approach was preliminarily proved to distinguish the intra-articular from extra-articular needle placement in the knee joint. This study demonstrated a possible alternative electronic device implementation of this technique to detect the intra-articular knee injection.

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Non-surgical Treatment Recommendations for Knee Osteoarthritis

Kim

Ugur

Kim

2023

Curr Phys Med Rehabil Rep

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Accuracy comparisons of intra-articular knee injection between the new modified anterolateral Approach and superolateral approach in patients with symptomatic knee osteoarthritis without effusion

Cited by 8 publications

References 16 publications

Ultrasound-Guided Knee Injections Are More Accurate Than Blind Injections: A Systematic Review of Randomized Controlled Trials

Ultrasound-Guided Knee Injections Are More Accurate Than Blind Injections: A Systematic Review of Randomized Controlled Trials

A Vibration Sensor Approach to Detect Intra-Articular Needle Tip Placement in the Knee Joint

Non-surgical Treatment Recommendations for Knee Osteoarthritis

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