Knee | Basics of Ortho

Knee Injections

Supero-lateral Patella Knee Injections

1. Discuss the potential adverse affects of the procedure with the patient and obtain, at least, verbal consent, and have them supine on the exam table with the knee extended

2. Thoroughly palpate the pertinent landmarks, specifically the superior border, lateral border, and superolateral corner of the patella

3. Mark your injection site with a skin marker or make an impression with the needle cap

For superolateral patella approach, the entry site is approximately 1cm diagonally off of the superolateral corner of the patella.

4. Apply gloves (sterile gloves are not necessary)

5. Prep the site with antiseptic of choice (betadine, chlorhexadine, alcohol, etc.) x 3

6. Apply anesthetic of choice (Many use ethyl chloride topical spray, including me. It generally is not necessary to use an injectable anesthetic, but certainly is not wrong if you elect to do so. Some do not use an anesthetic at all.)

7. Visualize your needle insertion trajectory.

8. Insert the needle slowly and controlled

9. Once you are confident that your needle tip is within the joint capsule, slowly inject

10. Slowly withdraw the needle

11. Wipe area clean

12. Apply bandage (adhesive bandage or gauze/tape)

Antero-Lateral Jointline Knee Injection

1. Discuss the potential adverse affects of the procedure with the patient and obtain, at least, verbal consent, and have the patient seated with his/her knees flexed and legs dangling off of the exam table

2. Thoroughly palpate the landmarks pertinent to the procedure, specifically, the patellar tendon, inferior pole of the patella, and anterior lateral joint line