Advanced Applications of Home-Based Primary Care - Virtual Workshop-Knee Aspiration and Injection Procedure

Knee Aspiration and Injection Procedure

Pdf Summary

The Home Centered Care Institute (HCCI) provides a detailed guide for home-based primary care (HBPC) providers on performing knee aspirations and injections. The procedure aims to alleviate knee pain by aspirating effusion and injecting a corticosteroid directly into the synovial space.<br /><br />**Equipment:**<br />To perform the procedure, the following items are required: clean surface barrier, gloves, syringes (10-ml & 5-cc), hemostat, Povidone-Iodine or Chlorhexidine swabs, alcohol wipes, gauze, various needles (18-20 gauge for aspiration, 25 gauge for injection), anesthetics (Lidocaine 1%, Bupivacaine), corticosteroids (Betamethasone, Methylprednisolone, Triamcinolone), fluid collection containers, sterile cup, adhesive bandages, labels, sharps container, and optionally, an Ethyl Chloride spray.<br /><br />**Procedure:**<br />1. Counsel the patient and caregiver(s) about the risks and benefits.<br />2. Obtain consent and ensure it's documented.<br />3. Perform a safety time-out to verify patient identity and details.<br />4. Wash hands, don gloves, and position the patient supine with the knee slightly flexed.<br />5. Mark the injection site above and lateral or medial to the patella.<br />6. Clean the marked site with swabs and allow it to dry for two minutes.<br />7. Prepare corticosteroid and anesthetic syringes.<br />8. Administer local anesthetic if desired.<br />9. For aspiration, insert a needle at a 45-degree angle distally and inferiorly under the patella to draw the effusion.<br />10. Use a hemostat to switch to the corticosteroid syringe if effusion is present.<br />11. For direct corticosteroid injection without effusion, use a 25-gauge needle.<br />12. Post-procedure, press the puncture site with gauze, clean it with alcohol, and cover with a bandage.<br />13. Inform the patient and caregiver(s) about post-injection care and expectations.<br /><br />**Other Considerations:**<br />The procedure also includes billing codes and mentions contraindications such as infection, severe coagulopathy, and more than three injections per year. Complications can include infection, local trauma, hyperglycemia, and steroid flare.<br /><br />For further educational materials, HCCI provides resources such as webinars, virtual office hours, and downloadable tools through their HCCIntelligence Resource Center.

Keywords

Home Centered Care Institute

HBPC

knee aspiration

knee injection

corticosteroid

synovial space

procedure guide

anesthetic

effusion

post-injection care