In-Plane Ultrasound-Guided Knee Injection Through a Lateral Suprapatellar Approach

Abstract

Our study demonstrates that in-plane ultrasound-guided injection of the knee in semiflexion approaching the lateral suprapatellar recess is a safe and useful technique to administer intra-articular contrast solution, as an alternative method without radiation exposure.

Ultrasound guided anterior approach to intra‐articular injection of the knee

“…A variety of ultrasound guided and anatomically guided knee injection techniques have been described in the literature. 7,[17][18][19] These approaches use various combinations of ultrasound and anatomical landmarks to access the intra-articular space. One of the most common ultrasound guided methods accesses the joint space through the suprapatellar bursa and its anatomical connection to the intrarticular space.…”

“…One of the most common ultrasound guided methods accesses the joint space through the suprapatellar bursa and its anatomical connection to the intrarticular space. 17 Another common method uses anatomical guidance, where the needle is inserted lateral to the patella tendon of the flexed knee and directed medially until it encounters the hard end point of the medial femoral condyle. In this approach location in the joint space is supported by the positioning of the needle at point of entry and timing of the hard stop.…”

Comparison of Two Different Ozone Injection Sites for Knee Osteoarthritis, Tibio-femoral Joint versus Supra-patellar Recess: An Open Randomized Clinical Trial

“…Chagas-Neto FA et al [20] showed that in-plane ultrasound-guided injection of the knee in semiflexion approaching the lateral supra-patellar recess is a safe and useful technique administers intra-articular contrast solution, as an alternative method without radiation exposure. Park Y et al [34] showed that accuracy of ultrasound-guided supra-patellar bursal injection was more than blind approach.…”

“…In the study conducted by Curtis HM and Park Y [35] demonstrated that suprapatellar approach was safer than other approach for intra-articular injection. Such technique permits to control the needle throughout the entire procedure from the puncture site to the articular cavity, avoiding vital structures such as tendons and cartilage [20]. In our study, we performed this technique to increase the accuracy in order to compare two methods of approaching.…”

“…There have been an increasing number of image-guided procedures, including ultrasound, lately offering safer, comfortable, with fewer complications or adverse events and more efficient approaches to patients when compared with surgery or non-guided (blinded) procedures [19]. The method of in-plane ultrasound-guided knee injection through a lateral supra-patellar approach has been shown to be a safer when compared with other methods [20][21][22]. On the other hand, supra-patellar recess is an easy access point for injection and a little far away from intra-articular space.…”