Arthroscopic Assessment of Landmark-guided Knee Injection Accuracy: A Prospective Observational Study
American Journal of Physical Medicine and Rehabilitation, cilt.105, sa.10, ss.871-877, 2026 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 105 Sayı: 10
- Basım Tarihi: 2026
- Doi Numarası: 10.1097/phm.0000000000003057
- Dergi Adı: American Journal of Physical Medicine and Rehabilitation
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, CINAHL, EMBASE, MEDLINE, SportDiscus, Academic Search Ultimate (EBSCO)
- Sayfa Sayıları: ss.871-877
- Anahtar Kelimeler: Knee Joint, Injections, Arthroscopy, Clinical Competence
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Objective: – To arthroscopically assess the accuracy of landmark-guided knee injections performed without imaging guidance and examine the effect of operator experience on accuracy and procedure time. Design: – This single-center prospective observational study included adult patients undergoing knee arthroscopy for isolated meniscal pathology between April 2024 and December 2025. Landmark-guided injections were performed using the anterolateral “soft spot” approach, and intra-articular needle placement was assessed arthroscopically. Results: – A total of 162 patients were included. Correct intra-articular placement was confirmed in 118 cases (72.8%), whereas 44 injections (27.2%) were extra-articular or suboptimal. Injection accuracy increased significantly with operator experience (53.2%, 75.4%, and 87.0% across experience groups; P=0.006), while procedure time decreased significantly (P<0.001). Cartilage contact occurred in 14.2% and meniscal contact in 11.7% of cases. Placement accuracy was significantly lower in patients with body mass index ≥30 kg/m² (P=0.011). Conclusions: – Arthroscopy showed a substantial rate of suboptimal placement and tissue contact with landmark-guided knee injections. Although operator experience influenced both accuracy and procedure time, the findings highlight the limitations of landmark-guided techniques, particularly in patients with less reliable anatomic landmarks.