David F Dalury1. 1. Towson Orthopaedic Associates, 8322 Bellona Avenue, Suite 100, Towson, MD 21204.
Abstract
INTRODUCTION: Currently, a popular form of pain control following total knee arthroplasty is the use of periarticular injections; how the medications are injected is a critical step in the efficacy of this modality. STEP 1 SETUP: The setup includes the injection fluid and two control syringes with a 22-gauge needle. STEP 2 INJECT THE LATERAL FEMORAL PERIOSTEUM: Inject around the femur before placing the implants. STEP 3 INJECT THE POSTERIOR ASPECT OF THE CAPSULE: This is another area of rich innervation that needs to be injected carefully. STEP 4 INJECT THE MEDIAL PERIOSTEUM: Use a similar technique of slow small-volume injections, watching for the periosteal wheal or elevation off the bone. STEP 5 INJECT THE CAPSULE AND SKIN: Include the lateral gutter and proximal extensor mechanism as well as around the patella, with minimal injection into the skin. RESULTS: Careful injection technique improves the outcome of periarticular injections for pain control. Indications ContraindicationsPitfalls & Challenges.
INTRODUCTION: Currently, a popular form of pain control following total knee arthroplasty is the use of periarticular injections; how the medications are injected is a critical step in the efficacy of this modality. STEP 1 SETUP: The setup includes the injection fluid and two control syringes with a 22-gauge needle. STEP 2 INJECT THE LATERAL FEMORAL PERIOSTEUM: Inject around the femur before placing the implants. STEP 3 INJECT THE POSTERIOR ASPECT OF THE CAPSULE: This is another area of rich innervation that needs to be injected carefully. STEP 4 INJECT THE MEDIAL PERIOSTEUM: Use a similar technique of slow small-volume injections, watching for the periosteal wheal or elevation off the bone. STEP 5 INJECT THE CAPSULE AND SKIN: Include the lateral gutter and proximal extensor mechanism as well as around the patella, with minimal injection into the skin. RESULTS: Careful injection technique improves the outcome of periarticular injections for pain control. Indications ContraindicationsPitfalls & Challenges.