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Learning curves of two different techniques for the intra-articular injection of the knee joint under fluoroscopic guidance

  • MUSCULOSKELETAL RADIOLOGY
  • Published:
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A Correction to this article was published on 17 February 2018

This article has been updated

Abstract

Aim

The aim of the study was to compare the learning curves of three beginner operators using two different techniques of intra-articular injection of the knee under fluoroscopic guidance with a superolateral approach.

Materials and methods

In total, 177 consecutive patients (72 females (40.7%) and 105 males (59.3%), mean age 42.2 ± 15.0 years) scheduled for a computed tomography (CT) arthrography and without joint effusion on the lateral X-rays were enrolled. They underwent an intra-articular injection of the knee under fluoroscopic guidance with a superolateral approach. Patients were randomly assigned to three different operators, including a junior supervisor and two first-year residents in radiology who never performed an intra-articular injection of the knee before the present study. Procedures in lateral or supine position were randomly assigned to three operators.

Results

There was a higher rate of successful injections with the lateral position (92.1%) than with supine position (80.2%) (odds ratio (OR) 4.52, 95% confidence interval (CI) 1.46–14.0). A significant learning effect was observed for the supine position, while none was observed for the lateral position. Pain and time of fluoroscopy did not differ between the two procedures (p = 0.85 and p = 0.10, respectively). Junior supervisor had a higher rate of successful intra-articular injection compared with the other two operators (p = 0.0072). There was a statistically significant higher rate of extravasation with the supine position (66.3%) than with lateral position (19.7%) (p < 0.0001, OR 0.13, 95% CI 0.06–0.25).

Conclusion

The intra-articular injection of the knee under fluoroscopic guidance with the patient in lateral position is an easy technique for operators in training with a low rate of extravasation. Lateral position does not require a supplementary irradiation and does not increase the procedural pain. Personal operator’s skill is an independent factor in determining the success of the training.

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Change history

  • 17 February 2018

    The published version of this article contained a mistake. In Table 1 of the original article, the numbers of successful injections and failed injections were not correct. The correct Table 1 should read as given below:

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Acknowledgements

Adelin Albert, PhD, and Laurence Seidel, PhD, are kindly acknowledged for the statistical analysis.

Funding

Therefore, no fund was granted to the authors to perform this study.

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Authors and Affiliations

  1. “Reine Fabiola” Children’s University Hospital, Université Libre de Bruxelles (ULB), 15, Avenue Jean Joseph Crocq, 1020, Brussels, Belgium

    Paolo Simoni & Grammatina Boitsios

  2. Radiology Department, CHU de Liège, CHU du Sart Tilman, Bât. 35, 4000, Liège, Belgium

    Mounia El Hachemi & Angelo Tromba

  3. Rheumatology Department, CHU de Liège, CHU du Sart Tilman, Bât. 35, 4000, Liège, Belgium

    Paolo Simoni & Olivier Malaise

Authors
  1. Paolo Simoni
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  2. Olivier Malaise
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  3. Mounia El Hachemi
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  4. Angelo Tromba
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  5. Grammatina Boitsios
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Corresponding author

Correspondence to Paolo Simoni.

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The authors declare no conflicts of interest to declare.

Ethical standards

No animals were involved in the present study. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

The local institutional ethics committee approved the study, and an informed consent was obtained from all individual participants included in the study.

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Simoni, P., Malaise, O., El Hachemi, M. et al. Learning curves of two different techniques for the intra-articular injection of the knee joint under fluoroscopic guidance. Radiol med 123, 359–366 (2018). https://doi.org/10.1007/s11547-017-0847-2

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  • DOI: https://doi.org/10.1007/s11547-017-0847-2

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