Validation of a Novel Landmark-guided Intra-articular Postero-medial Surgeon-administered Injection Technique
Background: This study aimed to define an intra-articular surgeon-administered technique that may be comparable to ultrasound (US)-guided adductor canal block (ACB). Methods: Five cadaver lower limbs were examined. An anesthesiologist administered a US-guided ACB using 20 mL of dilute indocyanine dy...
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| Format: | Article |
| Language: | English |
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Elsevier
2025-02-01
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| Series: | Arthroplasty Today |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2352344125000068 |
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| author | Nicolas S. Piuzzi, MD Andrew I. Spitzer, MD Jason Mussell, PhD Ignacio Pasqualini, MD Stan Dysart, MD Jeffrey Gonzales, MD Michael A. Mont, MD Jess H. Lonner, MD William Mihalko, MD, PhD |
| author_facet | Nicolas S. Piuzzi, MD Andrew I. Spitzer, MD Jason Mussell, PhD Ignacio Pasqualini, MD Stan Dysart, MD Jeffrey Gonzales, MD Michael A. Mont, MD Jess H. Lonner, MD William Mihalko, MD, PhD |
| author_sort | Nicolas S. Piuzzi, MD |
| collection | DOAJ |
| description | Background: This study aimed to define an intra-articular surgeon-administered technique that may be comparable to ultrasound (US)-guided adductor canal block (ACB). Methods: Five cadaver lower limbs were examined. An anesthesiologist administered a US-guided ACB using 20 mL of dilute indocyanine dye. An orthopedic surgeon performed a medial parapatellar arthrotomy and introduced an 18-gauge needle 1-2 cm proximal to the palpated adductor tubercle angled posteromedially. Needle position and dye spread were fluoroscopically documented. Results: This technique consistently reached the infrapatellar branch of the saphenous nerve, nerve to the vastus medialis muscle, and posterior capsule, with minimal proximal dye spread. Conclusions: This technique may be an efficient complement to ACB or surgeon infiltration or an alternative to US-guided ACB when it is not available. |
| format | Article |
| id | doaj-art-c7ad49204d264785baad2855ff5110d6 |
| institution | Kabale University |
| issn | 2352-3441 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Arthroplasty Today |
| spelling | doaj-art-c7ad49204d264785baad2855ff5110d62025-02-10T04:34:33ZengElsevierArthroplasty Today2352-34412025-02-0131101619Validation of a Novel Landmark-guided Intra-articular Postero-medial Surgeon-administered Injection TechniqueNicolas S. Piuzzi, MD0Andrew I. Spitzer, MD1Jason Mussell, PhD2Ignacio Pasqualini, MD3Stan Dysart, MD4Jeffrey Gonzales, MD5Michael A. Mont, MD6Jess H. Lonner, MD7William Mihalko, MD, PhD8Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, OH, USA; Corresponding author. Cleveland Clinic, 9500 Euclid Avenue, Mail Code A40, Cleveland, OH 44195, USA.Tel.: +1 216 445 9109.Department of Orthopaedic Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USADepartment of Orthopaedic Surgery, Louisiana State University Health Sciences Center, New Orleans, LA, USADepartment of Orthopaedic Surgery, Cleveland Clinic, Cleveland, OH, USAPacira BioSciences, Inc., Tampa, FL, USAPacira BioSciences, Inc., Tampa, FL, USADepartment of Orthopaedic Surgery, Sinai Hospital of Baltimore, Baltimore, MD, USARothman Orthopaedics, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA, USAUniversity of Tennessee Health Science Center, Campbell Clinic Department of Orthopaedic Surgery, Memphis, TN, USABackground: This study aimed to define an intra-articular surgeon-administered technique that may be comparable to ultrasound (US)-guided adductor canal block (ACB). Methods: Five cadaver lower limbs were examined. An anesthesiologist administered a US-guided ACB using 20 mL of dilute indocyanine dye. An orthopedic surgeon performed a medial parapatellar arthrotomy and introduced an 18-gauge needle 1-2 cm proximal to the palpated adductor tubercle angled posteromedially. Needle position and dye spread were fluoroscopically documented. Results: This technique consistently reached the infrapatellar branch of the saphenous nerve, nerve to the vastus medialis muscle, and posterior capsule, with minimal proximal dye spread. Conclusions: This technique may be an efficient complement to ACB or surgeon infiltration or an alternative to US-guided ACB when it is not available.http://www.sciencedirect.com/science/article/pii/S2352344125000068KneeArthroplastyTotal knee arthroplastyAnesthesiaPain |
| spellingShingle | Nicolas S. Piuzzi, MD Andrew I. Spitzer, MD Jason Mussell, PhD Ignacio Pasqualini, MD Stan Dysart, MD Jeffrey Gonzales, MD Michael A. Mont, MD Jess H. Lonner, MD William Mihalko, MD, PhD Validation of a Novel Landmark-guided Intra-articular Postero-medial Surgeon-administered Injection Technique Arthroplasty Today Knee Arthroplasty Total knee arthroplasty Anesthesia Pain |
| title | Validation of a Novel Landmark-guided Intra-articular Postero-medial Surgeon-administered Injection Technique |
| title_full | Validation of a Novel Landmark-guided Intra-articular Postero-medial Surgeon-administered Injection Technique |
| title_fullStr | Validation of a Novel Landmark-guided Intra-articular Postero-medial Surgeon-administered Injection Technique |
| title_full_unstemmed | Validation of a Novel Landmark-guided Intra-articular Postero-medial Surgeon-administered Injection Technique |
| title_short | Validation of a Novel Landmark-guided Intra-articular Postero-medial Surgeon-administered Injection Technique |
| title_sort | validation of a novel landmark guided intra articular postero medial surgeon administered injection technique |
| topic | Knee Arthroplasty Total knee arthroplasty Anesthesia Pain |
| url | http://www.sciencedirect.com/science/article/pii/S2352344125000068 |
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