Knee Surg Relat Res.  2015 Dec;27(4):228-232. 10.5792/ksrr.2015.27.4.228.

Anterolateral Portal Is Less Painful than Superolateral Portal in Knee Intra-Articular Injection

• Lee SY
• GN KK
• Chung BJ
• Lee SW
• Kim TK

• KMID: 2149676
• DOI: http://doi.org/10.5792/ksrr.2015.27.4.228

Abstract

PURPOSE
Intra-articular knee injections are commonly performed in clinical practice for treating various knee joint disorders such as osteoarthritis and rheumatoid arthritis. When selecting the portal for injection, not only intra-articular needle accuracy but also procedural pain should be taken into consideration. The purpose of this study was to determine whether injection through anterolateral portal provokes less pain and provides better pain relief compared to superolateral portal.
MATERIALS AND METHODS
A total of 60 patients with primary osteoarthritis of the knee receiving intra-articular injections were randomized into 2 groups according to the type of portal approach; anterolateral or superolateral. All patients received hyaluronic acid (20 mg) and triamcinolone (40 mg) as the first injection followed by second and third injections of hyaluronic acid on a weekly basis. Underlying knee pain, procedural pain, and knee pain at 4 weeks were evaluated using visual analogue scale (VAS).
RESULTS
Injection through anterolateral portal provoked less pain (VAS, 1.5+/-1.3) than the superolateral portal (VAS, 1.5 vs. 2.7; p=0.004). No differences were found in the degree of pain relief at weeks between the two groups (p=0.517).
CONCLUSIONS
We recommend the use of anterolateral portal for intra-articular knee injection as it provokes less pain and comparably short-term pain relief than the superolateral portal.

Keyword

Knee; Osteoarthritis; Intra-articular injection

MeSH Terms

Arthritis, Rheumatoid
Humans
Hyaluronic Acid
Injections, Intra-Articular*
Knee Joint
Knee*
Needles
Osteoarthritis
Triamcinolone
Hyaluronic Acid
Triamcinolone