Evaluation of loss of resistance technique using an air-filled injector to enhance accuracy of landmark-guided knee joint injections
Turkish Journal of Physical Medicine and Rehabilitation, cilt.72, sa.1, ss.93-98, 2026 (SCI-Expanded, Scopus, TRDizin)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 72 Sayı: 1
- Basım Tarihi: 2026
- Doi Numarası: 10.5606/tftrd.2026.16756
- Dergi Adı: Turkish Journal of Physical Medicine and Rehabilitation
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, TR DİZİN (ULAKBİM)
- Sayfa Sayıları: ss.93-98
- Anahtar Kelimeler: Anatomic landmarks, corticosteroids, injections, intra-articular, knee, osteoarthritis
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Objectives: This study aims to compare the accurate intra-articular contrast distribution ratios between the loss of resistance with an air-filled injector (AFI) technique and the traditional landmark-guided knee injection in patients with knee osteoarthritis (OA). Patients and methods: Between July 2023 and December 2023, a total of 65 patients (8 males, 57 females; mean age: 65.6±8.3 years; range, 51 to 84 years) with Kellgren-Lawrence Stage 2-4 knee OA were randomly assigned to two groups as Group 1 (n=33) who were injected with a mixture of a contrast agent and triamcinolone hydrochloride and as Group 2 (n=32) who were injected with a 5-mL syringe containing 2 mL of air. After the air in the syringe was removed by loss of resistance, a mixture of contrast agent and triamcinolone hydrochloride was injected. Data including demographic and clinical characteristics of the patients were recorded. The contrast distribution was visualized by f luoroscopy in both groups. The patient's pain after the knee injection was evaluated using the Visual Analog Scale (VAS). Results: The groups were similar in terms of age, sex, body mass index, Kellgren-Lawrence stage, VAS score, duration of knee pain, and pain during knee injection (p>0.05). The accurate intra-articular contrast distribution ratios were 66.7% and 90.6% in Groups 1 and 2, respectively (p=0.019). No variable was found to be associated with an accurate intra-articular injection ratio. Conclusion: The AFI loss of resistance technique may significantly enhance the accuracy of landmark-guided knee injections and serve as a practical alternative in outpatient settings where imaging is unavailable.