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Article Dans Une Revue Journal of Ultrasound in Medicine Année : 2022

Ultrasound-Guided Perimeniscal Injections: Anatomical Description and Feasibility Study

Résumé

OBJECTIVES: To anatomically describe the ultrasound (US)-guided perimeniscal injection technique, and evaluate its feasibility in the treatment of meniscal pain. METHODS: This work was initially undertaken in four cadaveric specimens with US-guided medial and lateral perimeniscal injection of China ink, followed by cadaveric dissection to assess injectate distribution, and potential injury to intra-articular and peri-articular structures. Then, 35 consecutive patients who underwent US-guided perimeniscal corticosteroid injection under local anesthesia for the treatment of symptomatic medial (30/35) or lateral (5/35) degenerative meniscal tear were retrospectively evaluated. Clinical outcome was assessed using a 0-10 numerical verbal rating scale (VRS) to evaluate severity of pain before, during, and after procedure at 6 weeks follow-up. RESULTS: Seven of eight (87.5%) ex vivo injections were accurate. A single inaccurate medial perimeniscal injection infiltrated the tibial collateral ligament instead of the perimeniscal area. No anatomical specimen exhibited intrameniscal injection or injury to regional structures. All procedures (35/35) performed clinically were technically successful. Median VRS scores were: 7 (range, 3-9) before procedure, 5 (range, 0-10) during procedure, and 1.5 (range, 0-9) after procedure at 6 weeks follow-up (P \textless.0001). No complication was observed. CONCLUSIONS: US-guided perimeniscal injections can accurately and safely deliver injectates in the perimeniscal area. In addition, our data suggest that perimeniscal corticosteroid injection provides significant symptom relief at 6 weeks in patients with meniscal pain. Further studies with long-term follow-up will be required to evaluate the role of perimeniscal injections in the nonoperative management of meniscal pathology.
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Dates et versions

hal-03553760 , version 1 (09-03-2023)

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Clemence Coll, Jean-Marie Coudreuse, Daphne Guenoun, Laurent Bensoussan, Jean-Michel Viton, et al.. Ultrasound-Guided Perimeniscal Injections: Anatomical Description and Feasibility Study. Journal of Ultrasound in Medicine, 2022, 41 (1), pp.217--224. ⟨10.1002/jum.15700⟩. ⟨hal-03553760⟩
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