30 Aug Knee Injection Technique
The knee joint is the most commonly and easily accessed joint of the body. Knee joint injections are performed to provide access to the joint space for diagnostic and therapeutic purposes. Steroids or other medications can be injected intra-articularly in the knee joint.
Intra-articular knee injection technique
The patient is placed on the procedure table. The injection site is sterilized with iodine or chlorhexidine, followed by a local anesthetic injection to numb the area. Then, the needle is directed at a 45-degree angle distally and 45 degrees into the knee, tilted below the patella (typically, from the lateral side). X-ray guidance may be used to ensure proper placement and positioning of the needle. A contrast agent may be injected to further establish that the needle is in the proper position. Once proper needle placement is confirmed, the medication solution is slowly administered. Following this, the skin is cleansed and a bandage is applied over the injection site.
What to expect?
Knee injection can be very painful. In addition to a local anesthetic agent, IV sedation may be considered to make the procedure pain-free. Getting IV sedation will require the patient to have a driver for commuting. It will require the patient to have had nothing to eat or drink within 6 hours of the procedure. Furthermore, the patient cannot drive or operate machinery for at least 24 hours after the procedure. They may return to work the next day and resume your normal diet immediately. Patients should be advised to abstain from strenuous activity for 24 hours. They are also instructed not to take a bath, swim, or use a hot tub for 24 hours, but taking a shower is allowed. They should report to the doctor if they have severe pain afterwards, redness/swelling/discharge at the injection site or fevers/chills.
The complication rates are very low for this procedure and include bleeding or infection, and extremely rarely, paralysis or death. Allergic reaction to the medications used is possible. Getting a proper allergic history is crucial.
Common side effects include:
- Leg muscle weakness or numbness – this is due to the local anesthetic used and should be temporary.
- Dizziness – due to low blood pressure.
- Mild headaches – taking fluids and pain medications helps.
- Mild discomfort – common and lasts for a few hours.
Concerning side effects that require medical attention include:
- Severe or worsening pain at the injection site
- Limb weakness that worsens or persists for longer than 8 hours.
- Severe or worsening redness, swelling, or discharge from the injection site.
- Fevers, chills, nausea, or vomiting
- Bowel or bladder dysfunction