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BMC Sports Science, Medicine and Rehabilitation
Published in: BMC Sports Science, Medicine and Rehabilitation 1/2011

Open Access 01-12-2011 | Research

The highly accurate anteriolateral portal for injecting the knee

Authors: Colbert E Chavez-Chiang, Wilmer L Sibbitt Jr, Philip A Band, Natalia R Chavez-Chiang, Suzanne L DeLea, Arthur D Bankhurst

Published in: BMC Sports Science, Medicine and Rehabilitation | Issue 1/2011

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Abstract

Background

The extended knee lateral midpatellar portal for intraarticular injection of the knee is accurate but is not practical for all patients. We hypothesized that a modified anteriolateral portal where the synovial membrane of the medial femoral condyle is the target would be highly accurate and effective for intraarticular injection of the knee.

Methods

83 subjects with non-effusive osteoarthritis of the knee were randomized to intraarticular injection using the modified anteriolateral bent knee versus the standard lateral midpatellar portal. After hydrodissection of the synovial membrane with lidocaine using a mechanical syringe (reciprocating procedure device), 80 mg of triamcinolone acetonide were injected into the knee with a 2.0-in (5.1-cm) 21-gauge needle. Baseline pain, procedural pain, and pain at outcome (2 weeks and 6 months) were determined with the 10 cm Visual Analogue Pain Score (VAS). The accuracy of needle placement was determined by sonographic imaging.

Results

The lateral midpatellar and anteriolateral portals resulted in equivalent clinical outcomes including procedural pain (VAS midpatellar: 4.6 ± 3.1 cm; anteriolateral: 4.8 ± 3.2 cm; p = 0.77), pain at outcome (VAS midpatellar: 2.6 ± 2.8 cm; anteriolateral: 1.7 ± 2.3 cm; p = 0.11), responders (midpatellar: 45%; anteriolateral: 56%; p = 0.33), duration of therapeutic effect (midpatellar: 3.9 ± 2.4 months; anteriolateral: 4.1 ± 2.2 months; p = 0.69), and time to next procedure (midpatellar: 7.3 ± 3.3 months; anteriolateral: 7.7 ± 3.7 months; p = 0.71). The anteriolateral portal was 97% accurate by real-time ultrasound imaging.

Conclusion

The modified anteriolateral bent knee portal is an effective, accurate, and equivalent alternative to the standard lateral midpatellar portal for intraarticular injection of the knee.

Trial Registration

ClinicalTrials.gov: NCT00651625
Appendix
Available only for authorised users
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Metadata
Title
The highly accurate anteriolateral portal for injecting the knee
Authors
Colbert E Chavez-Chiang
Wilmer L Sibbitt Jr
Philip A Band
Natalia R Chavez-Chiang
Suzanne L DeLea
Arthur D Bankhurst
Publication date
01-12-2011
Publisher
BioMed Central
Published in
BMC Sports Science, Medicine and Rehabilitation / Issue 1/2011
Electronic ISSN: 2052-1847
DOI
https://doi.org/10.1186/1758-2555-3-6

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