BACKGROUND: Several studies have been performed suggesting that a superolateral approach to @entity821 injections for symptomatic @entity571 of the knee is more accurate than anteromedial or anterolateral approaches, but there are little data to correlate clinical outcomes with these results. Additionally, there are minimal data to evaluate the @entity158 of such procedures, and this consideration may impact physician preferences for a preferred approach to knee injection. PURPOSE: To determine the comparative efficacy and tolerability ( @entity1 comfort) of landmark-guided @entity821 injections at 3 commonly used portals into the arthritic knee without effusion. STUDY DESIGN: Randomized controlled trial; Level of evidence, 1. METHODS: Adult, English-speaking @entity1 presenting to a sports medicine clinic with knee @entity158 attributed to radiographically proven grades I through III knee @entity571 were randomized to receive a @entity821 injection via superolateral, anteromedial, or anterolateral approaches. @entity1 used a visual analog scale (VAS) to self-report comfort with the procedure. Western Ontario and McMaster Universities Arthritis Index (WOMAC) 3.1 VAS scores were used to establish baseline @entity158 and dysfunction prior to the injection and at 1 and 4 weeks follow-up via mail. RESULTS: A total of 55 knees from 53 @entity1 were randomized for injection using a superolateral approach (17 knees), an anteromedial approach (20 knees), and an anterolateral approach (18 knees). The mean VAS scores for procedural discomfort showed no significant differences between groups (superolateral, 39.1    28.5; anteromedial, 32.9    31.5; anterolateral, 33.1    26.6; P = .78). WOMAC scores at baseline were similar between groups as well (superolateral, 1051    686; anteromedial, 1450    573; anterolateral, 1378    673; P = .18). The WOMAC scores decreased at 1 and 4 weeks for all groups, with no significant differences in reduction between the 3 groups. CONCLUSION: Other studies have shown that the superolateral portal is the most accurate. This study did not assess accuracy, but it showed that all 3 knee injection sites studied have similar overall clinical benefit at 4-week follow-up. Procedural @entity158 was not significantly different between groups.

Tolerability and Efficacy of 3 Approaches to Intra-articular Corticosteroid Injections of the Knee for XXXX : A Randomized Controlled Trial.

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients', 'patient'] @entity821 :: ('MESH:D003348', 'Chemical') :: ['cortisone'] @entity571 :: ('MESH:D010003', 'Disease') :: ['osteoarthritis'] @entity158 :: ('MESH:D010146', 'Disease') :: ['pain']
@entity571 :: (MESH:D010003,Disease) :: ['Osteoarthritis']
