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Ultrasound-Guided Knee Injections Are More Accurate Than Blind Injections: A Systematic Review of Randomized
William H Fang1, Xiao T Chen1, C Thomas Vangsness1
1Department of Orthopaedic Surgery, Keck School of Medicine of USC, Los Angeles, California, U.S.A.
Arthroscopy, Sports Medicine, and Rehabilitation
|August 25, 2021
Summary
Ultrasound-guided knee injections are more accurate than blind injections. The isometric quadricep contraction with a superolateral approach offers the greatest accuracy for intra-articular knee access.
Area of Science:
- Orthopedic surgery
- Medical imaging
Background:
- Accurate intra-articular knee injections are crucial for effective treatment.
- Various techniques and needle placements exist, but their comparative accuracy is debated.
Purpose of the Study:
- To determine the most accurate injection technique and needle portal for intra-articular knee access.
- To compare the accuracy of ultrasound-guided versus blind knee injections.
Main Methods:
- Systematic review of Level I studies following PRISMA guidelines.
- Literature search of PubMed, MEDLINE, and Cochrane Library databases.
- Data extraction on injection accuracy, study design, and validation methods; Jadad score for quality assessment.
Main Results:
- Twelve Level I studies (1431 patients) were included.
- Ultrasound-guided injections demonstrated superior accuracy compared to blind injections in all comparative studies.
- The isometric quadricep contraction with a superolateral approach was identified as the most accurate method.
Conclusions:
- Ultrasound guidance significantly enhances the accuracy of intra-articular knee injections across all anatomical sites.
- Blind injection accuracy is variable and highly dependent on the chosen entry portal.
