Ultrasound-Guided Perimeniscal Injections: Anatomical Description and Feasibility Study.

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Tytuł:: Ultrasound-Guided Perimeniscal Injections: Anatomical Description and Feasibility Study.
Autorzy:: Coll C; Physical and Rehabilitation Medicine Department, Aix Marseille University, APHM, INT, Inst Neurosci Timone, CHU Timone, Marseille, France.
Coudreuse JM; Physical and Rehabilitation Medicine Department, Aix Marseille University, APHM, INT, Inst Neurosci Timone, CHU Timone, Marseille, France.
Guenoun D; Radiology Department, APHM, Marseille, France.; Aix Marseille University, CNRS, ISM UMR, Marseille, France.
Bensoussan L; Physical and Rehabilitation Medicine Department, Aix Marseille University, APHM, INT, Inst Neurosci Timone, CHU Timone, Marseille, France.
Viton JM; Physical and Rehabilitation Medicine Department, Aix Marseille University, APHM, INT, Inst Neurosci Timone, CHU Timone, Marseille, France.
Champsaur P; Radiology Department, APHM, Marseille, France.; Aix Marseille University, CNRS, ISM UMR, Marseille, France.
Le Corroller T; Radiology Department, APHM, Marseille, France.; Aix Marseille University, CNRS, ISM UMR, Marseille, France.
Źródło:: Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine [J Ultrasound Med] 2022 Jan; Vol. 41 (1), pp. 217-224. Date of Electronic Publication: 2021 Mar 31.
Typ publikacji:: Journal Article
Język:: English
Imprint Name(s):: Publication: 2017- : Oxford, UK : John Wiley and Sons
Original Publication: [Philadelphia, Pa.] : W.B. Saunders, c1982-
MeSH Terms:: Ultrasonography, Interventional*
Feasibility Studies ; Humans ; Injections ; Retrospective Studies ; Ultrasonography
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Contributed Indexing:: Keywords: anatomy; knee; meniscus; ultrasound
Entry Date(s):: Date Created: 20210331 Date Completed: 20211220 Latest Revision: 20211220
Update Code:: 20240104
DOI:: 10.1002/jum.15700
PMID:: 33788316
: Czasopismo naukowe

Objectives: To anatomically describe the ultrasound (US)-guided perimeniscal injection technique, and evaluate its feasibility in the treatment of meniscal pain.
Methods: This work was initially undertaken in four cadaveric specimens with US-guided medial and lateral perimeniscal injection of China ink, followed by cadaveric dissection to assess injectate distribution, and potential injury to intra-articular and peri-articular structures. Then, 35 consecutive patients who underwent US-guided perimeniscal corticosteroid injection under local anesthesia for the treatment of symptomatic medial (30/35) or lateral (5/35) degenerative meniscal tear were retrospectively evaluated. Clinical outcome was assessed using a 0-10 numerical verbal rating scale (VRS) to evaluate severity of pain before, during, and after procedure at 6 weeks follow-up.
Results: Seven of eight (87.5%) ex vivo injections were accurate. A single inaccurate medial perimeniscal injection infiltrated the tibial collateral ligament instead of the perimeniscal area. No anatomical specimen exhibited intrameniscal injection or injury to regional structures. All procedures (35/35) performed clinically were technically successful. Median VRS scores were: 7 (range, 3-9) before procedure, 5 (range, 0-10) during procedure, and 1.5 (range, 0-9) after procedure at 6 weeks follow-up (P <.0001). No complication was observed.
Conclusions: US-guided perimeniscal injections can accurately and safely deliver injectates in the perimeniscal area. In addition, our data suggest that perimeniscal corticosteroid injection provides significant symptom relief at 6 weeks in patients with meniscal pain. Further studies with long-term follow-up will be required to evaluate the role of perimeniscal injections in the nonoperative management of meniscal pathology.
(© 2021 American Institute of Ultrasound in Medicine.)

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