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http://dx.doi.org/10.3344/kjp.2018.31.4.289

The comparison of two different intraarticular injections using a sonographic anterolateral approach in patients with osteoarthritic knee  

Choi, Jin Wook (Department of Anesthesiology and Pain Medicine, Chonbuk National University Medical School and Hospital)
Lee, Jun Ho (Department of Anesthesiology and Pain Medicine, Chonbuk National University Medical School and Hospital)
Ki, Minjong (Department of Anesthesiology and Pain Medicine, Chonbuk National University Medical School and Hospital)
Kim, Myung Jong (Department of Anesthesiology and Pain Medicine, Chonbuk National University Medical School and Hospital)
Kang, Sehrin (Department of Anesthesiology and Pain Medicine, Chonbuk National University Medical School and Hospital)
Lee, Juhyung (Department of Preventive Medicine, Chonbuk National University Medical School)
Lee, Jun-Rae (Department of Oral and Maxillofacial Surgery, Chonbuk National University School of Dentistry)
Han, Young-Jin (Department of Anesthesiology and Pain Medicine, Chonbuk National University Medical School and Hospital)
Son, Ji-Seon (Department of Anesthesiology and Pain Medicine, Chonbuk National University Medical School and Hospital)
Publication Information
The Korean Journal of Pain / v.31, no.4, 2018 , pp. 289-295 More about this Journal
Abstract
Background: The intraarticular (IA) injection has become popular for the management of the osteoarthritic knee without an effusion. The success rate of IA injection would be better if it was able to be visually confirmed. We hypothesized that an anterolateral approach, which targets the synovial membrane of the lateral condyle using ultrasound, would provide an equivalent alternative to the anterolateral approach, targeting the synovial membrane of the medial condyle for IA injection of the knee. Methods: A total of 96 knees with osteoarthritis were randomized placed into the two groups, which were group I (anterolateral approach to the medial condyle) and group II (anterolateral approach to the lateral condyle). The primary outcome was to compare the success rate of the two methods of IA injection. The required length of the needle for injection was also measured and compared. Pain intensity was assessed using the Numeric Rating Scale in order to evaluate the success of injection. Results: There were no significant differences in the success rate between both groups. The success rate of group I and group II were 87.8% (95%, CI 78.7-97.0) and 91.5% (95%, CI 83.6-99.5), respectively (P = 0.549). The needle depth was $5.0{\pm}0.8$ (3.0 to 6.1 cm) in group I, and $3.0{\pm}0.8$ (1.5 to 5 cm) in group II (P < 0.001). Conclusions: The anterolateral approach to the lateral femoral condyle, using ultrasound, is an alternative method to the approach targeting the medial femoral condyle, using shorter needle.
Keywords
Epiphyses; Femoral condyle; Intraarticular injections; Knee joint; Needle; Osteoarthritis; Synovial membrane; Ultrasound;
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