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Updated: Feb 25, 2026

Knee Arthrocentesis in Adults
Published on: February 25, 2022
Arthrocentesis and Joint Injection in Patients Receiving Direct Oral Anticoagulants
Jennifer C Yui1, Carina Preskill1, Laura S Greenlund1
1Department of Medicine, Division of Primary Care Internal Medicine, Mayo Clinic, Rochester, MN.
Abstract:
Anticoagulation is common in patients undergoing arthrocentesis and joint injections. Previous studies have established the safety of continuing anticoagulation with warfarin before joint aspirations/injections with only a small increased risk of bleeding, but no data are available regarding the use of direct oral anticoagulants (DOACs) and joint aspirations/injections. The objective of this study was to determine the rate of bleeding complications associated with arthrocentesis and joint injection in patients receiving DOACs. We performed a retrospective review of adult patients at Mayo Clinic in Rochester, Minnesota, who were being treated with DOACs and underwent outpatient joint aspiration and/or injection between October 1, 2010, and October 31, 2016. In 1050 consecutive procedures, there were no bleeding complications. Arthrocentesis and joint injections in patients receiving DOAC therapy are safe procedures, and there is no need to withhold anticoagulation treatment before the procedure.
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