What is the evidence for improving the accuracy of knee injections?
AMSTAR Rating
Summary
Patient Population:
No information on the patient population was provided.
Intervention:
Intra-articular injections of the knee.
Comparison:
27 studies were identified for inclusion in the review; none were considered Level 1 studies. 4 studies considered 3 injection approaches: medial, lateral and lateral mid-patellar.
Outcome:
- Injection Site Approaches: For the medial approach (130 injections), the average accuracy was 70% (range= 62-75%); for injections in the lateral aspect (n=169), average accuracy was 83% (range = 71-97), and 84% (range= 70-93) for lateral mid-patellar injections (n=130). There was no significant difference between approaches in terms of injection accuracy (Chi-square value is unreported, but the p-value =0.36).
- Imaging and Intra-articular injection in the knee: 7 studies were identified that assess accuracy of needle placement withU/S guidance. In these studies a total of 75 knees were injected with guidance (ave. accuracy rate = 99%; range = 95-100), 585 without (ave. accuracy rate = 79%; range=40-100). Chi-square testing revealed a significant difference in accuracy between guided and un-guided injection.
