Evaluation of the Medial Parapatellar Knee Injection Technique
The goal of our study is to present important anatomic considerations which should be considered before knee injection is performed. Additionally, we have developed important procedural augments to the traditional para-patellar injection techniques in order to exceed the accuracy and safety previously reported for the infra-patellar approaches We have developed an injection technique which mechanically is similar to current techniques practiced and poses no additional risks or discomfort to the patient. The basis of our technique and its success is through recognition of anatomic factors and avoidance of possible iatrogenic injuries which exist when using other knee injection technique. The focus of our study is to validate the clinical accuracy we have been obtaining using our technique through fluoroscopically confirmed visualized confirmation of repeated intra-articular deposit. Additionally we want to document the range of needle length we require to properly access the knee joint in our population to substantiate the importance of needle length. Needle length is a critical factor in obese patients whom have larger infra-patellar fat pads.
Our hypothesis is that when using a 6 inch 22 gage needle for intra-articular knee injections through the medial joint line approach, while utilizing the medial wall of the lateral femoral condyle as an intra-articular stop point for needle insertion, the accuracy of intra-articular deposit will exceed the values currently reported in the literature which is approximately 75% success rate.
To prove this point we will be injecting 2 cc of radiocontrast dye into the joint space and than immediatly view the joint flouroscopicly after the knee has been brought through 10 cycles of flexion and extension.
Accuracy of Intraarticular Needle Placement
|Study Design:||Observational Model: Cohort
Time Perspective: Prospective
|Official Title:||Evaluation of the Effectiveness of the Medial Parapatellar Knee Injection Technique|
- The percentage of successfull intra-articular deposits of radiocontrast dye into the knee joint using our medial parapatellar joint line approach and comparison of this value to previously reported values in the literature [ Time Frame: one year ] [ Designated as safety issue: No ]
- The length of the needle which is required to successfully transverse the infrapatellar fat pad in order to deposit injectate into the knee joint [ Time Frame: one year ] [ Designated as safety issue: No ]
|Study Start Date:||July 2008|
|Study Completion Date:||July 2009|
|Primary Completion Date:||July 2009 (Final data collection date for primary outcome measure)|
Patients enrolled in this study are those whom present to our institution for elective knee arthroscopy. All patients scheduled to receive a knee arthroscopy scheduled through the office of Dr. Harold Battenfield will be asked to participate in the study on the day of their procedure as long as they do not fall into one of the exclusion criteria categories.
Patients will not be allowed to participate in this study if they have an allergy to iodine or shell fish, if they have a knee effusion diagnosed clinically on the day of surgery, if the knee or surrounding tissues display cellulitis or other signs of infection, or if the patient has had a traumatic accident to their knee which significantly changes its anatomical relationships
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Please refer to this study by its ClinicalTrials.gov identifier: NCT00712972
|United States, Oklahoma|
|Oklahoma State University Collage of Health Sciences|
|Tulsa, Oklahoma, United States, 74107|
|Principal Investigator:||Harold L Battenfield, D.O.||Oklahoma State University|