Validation of a Novel Landmark-guided Intra-articular Postero-medial Surgeon-administered Injection Technique

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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Main Authors: 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
Format: Article
Language:English
Published: Elsevier 2025-02-01
Series:Arthroplasty Today
Subjects:
Knee
Arthroplasty
Total knee arthroplasty
Anesthesia
Pain
Online Access:http://www.sciencedirect.com/science/article/pii/S2352344125000068
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Summary: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.
ISSN:2352-3441

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