Meniscus‐Targeted Injections for Chronic Knee Pain Due to Meniscal Tears or Degenerative Fraying: A Retrospective Study

Abstract

Objectives Meniscal tears caused by acute trauma or degenerative fraying affect a wide array of individuals. An effective, long‐lasting treatment has widely been sought after. Intra‐articular corticosteroid injections have been among the methods of controlling pain for more than 60 years. However, such injections tend to produce short‐lasting results, with profound effects lasting an average of up to 4 weeks. The purpose of this study was to determine the average duration and magnitude of pain relief after meniscal‐targeted injections. Methods The electronic medical records of 135 patients were accessed for this retrospective chart review. Patients who had meniscal tears or degenerative fraying and were treated with meniscal‐targeted injections were selected. Patients’ visual analog scale (VAS) pain scores (before and after treatment) were recorded, along with the percentage of pain relief and duration of pain relief. Results Ultrasound‐guided meniscus‐targeted corticosteroid injections for meniscal tears or degenerative fraying produced 5.68 (SD, 5.28) weeks of pain relief on average, with a decrease in pain from initial to follow‐up visits of 2.14 (P < .0001) as per the visual analog scale score, and an Integral of Pain Relief score of 3.98. Conclusions Our findings indicate a substantial benefit from 20‐ or 40‐mg meniscus‐targeted triamcinolone injections, granted the limitations of chart review research and no control group comparison. Results highlight the need for future prospective research comparing meniscus‐targeted injections with intra‐articular injections to identify a better modality for treating patients with chronic knee pain caused by meniscal tears or degenerative fraying.

Leveraging Electrostatic Interactions for Drug Delivery to the Joint

“…29 Although the cartilage or the synovium are key targets for injectable therapeutics, these other tissues are also potential targets and often become depots for off-target accumulation. 30 For the purposes of this review, only the cartilage, synovium, and synovial fluid, tissues that are consistent across all synovial joints, will be examined for targeting of drug delivery systems using electrostatic interactions.…”

Ultrasound‐Guided Perimeniscal Injections

“…The current surgical consensus is that intact meniscal tissue should be preserved as much as possible to avoid the degenerative results that may follow its removal 17 . Because conservative treatment is now the first‐line choice in symptomatic meniscal tears, meniscal pain is routinely treated with activity modification, quadriceps strengthening, anti‐inflammatory or analgesic medications, and intra‐articular or meniscus‐targeted injections 7,11‐13 . Thus, the objectives of the present study were to determine the accuracy of US‐guided perimeniscal injections by using cadaveric specimens, and then to evaluate the safety and preliminary clinical outcome of this technique in the treatment of meniscal pain.…”

“…In particular, at the knee, US offers high spatial resolution and exquisite soft tissue delineation, making it an ideal guidance modality for both intra‐ and extra‐articular injections 9,10 . However, experience with meniscus‐targeted injections for the treatment of knee pain due to degenerative meniscal tears is still limited 11,12 . In particular, there is a lack of description of the precise anatomical target that is referred to as either “parameniscal area,” “perimeniscal area,” or “meniscus wall” in the previously published case series 11,12 .…”

“…However, experience with meniscus‐targeted injections for the treatment of knee pain due to degenerative meniscal tears is still limited 11,12 . In particular, there is a lack of description of the precise anatomical target that is referred to as either “parameniscal area,” “perimeniscal area,” or “meniscus wall” in the previously published case series 11,12 . Other authors even combine during the same procedure perimeniscal injection with meniscal needling and intrameniscal injection 13 .…”

Clinical Outcomes of Ultrasound-Guided Transmeniscal Injection in Medial Compartment Knee Osteoarthritis

“…때문에 주사 후 관절강내 원하는 곳까지 도달하기 전에 많은 부분이 흡수되어 버릴 수 있다. 5,6) 따라서 최근 연구들은 무릎 내 병변에 직접 주사하려는 시도를 하고 있으며 원하는 위치에 주사 하기 위해서 실시간으로 해부학적 구조물을 확인할 수 있고, 간 편하고, 방사선 노출이 없는 초음파를 이용하고 있다. [7][8][9] 무릎의 골관절염은 생역학적 이유로 인하여 내측 구획에 호발 한다고 알려져 있으며, 이로 인해서 주로 내측 통증이 많이 발생 한다.…”