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Periarticular Injection Technique to Enhance Pain Relief After Knee Arthroplasty
David F. Dalury, MD

Overview

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

Contraindications

Pitfalls & 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.

While many different medications can be used for periarticular injections, the technique of how and where the medication is administered is critical. An optimal volume (in this case 100 mL) facilitates adequate injection and infiltration of the critical areas. The injections should be delivered in a control syringe …


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