Usefulness of Fluoroscopy-Guided Intra-articular Injection of the Knee

Myung, Jae Kyung; Lee, Joon Woo; Lee, Ji Yeon; Choi, Ja-Young; Kim, Sung Hyun; Jun, Woo Sun; Kim, Na Ra; Kim, Joo Hyung; Jeong, Hee Sun; Hong, Sung Hwan; Jeon, Yong Hwan; Han, Heon; Kang, Heung Sik

doi:10.3348/jkrs.2007.56.6.563

Cited by 4 publications

(8 citation statements)

References 7 publications

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“…Twelve of 23 studies were RCTs, three non-RCTs, and eight observational studies. Twenty-two publications addressed accuracy of IAKIs and/or aspiration, seven assessed accuracy of IAKIs at different sites [14,15,21,22,28–30] , four at one injection site [20,31–33] , and 13 compared blinded and guided IAKIs [2,13,19,20,28,30,34–40] . Of the six studies that reviewed clinical outcomes, one was pertaining to accuracy of IAKI [29] , two compared between different knee injection sites [28,33] , and three compared outcomes between guided and blinded IAKIs [40,41] ( Table 1 ).…”

Section: Resultsmentioning

confidence: 99%

“…Others were single-blinded trials where either patients or injectors were not blinded to the intervention groups. For the observational studies, seven of eight studies fulfilled 10–18 of the 22 STROBE criteria [4,13,19,21,31,32,38] , while all three non-randomized trials had TREND scores of 10–15 of 22 [14,15,34] (see Supplementary Tables S1–S3 ).…”

Section: Resultsmentioning

confidence: 99%

“…With the medial midpatellar, the injection was made between patella and patellar groove of femur at mid medial patellar junction with the knee extended [21,33,37,39] . The superomedial patellar injection was performed with the needle inserted in a 45° cephalomedial to caudolateral direction between the femoral condyle and the lateral border of patella at the superior one-third margin of the patella with the knee extended [38] .…”

Section: Knee Joint Injection Sites and Approachesmentioning

confidence: 99%

See 2 more Smart Citations

Where and how to inject the knee—A systematic review

Maricar

Parkes

Callaghan

et al. 2013

Seminars in Arthritis and Rheumatism

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ObjectivesThe knee can be injected at different anatomic sites with or without image-guidance. We undertook a systematic review to determine the accuracy of intra-articular knee injection (IAKI) and whether this varied by site, use of image-guidance, and experience of injectors, and whether accuracy of injection, site, or use of image-guidance influenced outcomes following IAKIs.MethodsMedline, Embase, AMED, CINAHL, Web of Knowledge, Cochrane Central Registers for Controlled Trials up to Dec 2012 were searched for studies that evaluated either accuracy of IAKIs or outcomes related to accuracy, knee injection sites, or use of image-guidance. Within-study and between-study analyses were performed.ResultsData from 23 publications were included. Within-study analyses suggested IAKIs at the superomedial patellar, medial midpatellar (MMP), superolateral patellar (SLP) and lateral suprapatellar bursae sites were more accurate when using image-guidance than when blinded (ranges of pooled risk difference 0.09–0.19). Pooling data across studies suggested blinded IAKIs at the SLP site were most accurate (87%) while MMP (64%) and anterolateral joint line (ALJL) sites were (70%) least accurate. Overall about one in five blinded IAKIs were inaccurate. There was some evidence that experience of the injector was linked with improved accuracy for blinded though not image-guided injections. Based on a small number of studies, short but not longer-term outcomes for ultrasound-guided were found to be superior to blinded IAKIs.ConclusionsImage-guided IAKIs are modestly more accurate than blinded IAKIs especially at the MMP and ALJL sites. Blinded injections at SLP site had good accuracy especially if performed by experienced injectors. Further studies are required to address the question whether accurate localization is linked with an improved response.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Knee Joint Injection Sites and Approachesmentioning

confidence: 99%

See 1 more Smart Citation

Where and how to inject the knee—A systematic review

Maricar

Parkes

Callaghan

et al. 2013

Seminars in Arthritis and Rheumatism

View full text Add to dashboard Cite

show abstract

Section: Introductionmentioning

confidence: 99%

“…Imaging modalities, including fluoroscopy and ultrasound (US), have been shown to increase the accuracy of joint injections [16‐20]. Two studies reported 100% accuracy of fluoroscopically guided knee injections [16,17]. However, many limitations are associated with fluoroscopically guided injections, including radiation exposure to both the patient and the clinician, use of contrast, equipment expense, lack of portability, and specialized room requirements [16‐22].…”

Section: Introductionmentioning

confidence: 99%

Accuracy of Ultrasound‐Guided and Palpation‐Guided Knee Injections By an Experienced and Less‐Experienced Injector Using a Superolateral Approach: A Cadaveric Study

Curtiss

Finnoff

Peck

et al. 2011

PM&R

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US-guided knee injections that use a superolateral approach are very accurate in a cadaveric model, whereas the accuracy of palpation-guided knee injections that use the same approach is variable and appears to be significantly influenced by clinician experience. These findings suggest that US guidance should be considered when one performs knee injections with a superolateral approach that require a high degree of accuracy.

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Intra-articular Injection Therapy and Biologic Treatment

Seo

Lee

2021

A Strategic Approach to Knee Arthritis Treatment

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Usefulness of Fluoroscopy-Guided Intra-articular Injection of the Knee

Cited by 4 publications

References 7 publications

Where and how to inject the knee—A systematic review

Where and how to inject the knee—A systematic review

Accuracy of Ultrasound‐Guided and Palpation‐Guided Knee Injections By an Experienced and Less‐Experienced Injector Using a Superolateral Approach: A Cadaveric Study

Intra-articular Injection Therapy and Biologic Treatment

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