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Revista de la Facultad de Medicina Humana

English Title

Vías de acceso para la infiltración de viscosuplementación en rodillas de pacientes con gonartrosis grado II-III

Keywords

Articular injection, Gonarthrosis, Knee joint

English Keywords

Infiltración articular, Gonartrosis, Punción articular, rodilla

Abstract

Introduction: Knee joint injection is a daily procedure in orthopedic outpatient visit. In order to obtain the maximum therapeutic benefit, it is necessary to perform the injection directly into the articular space and not into the adjacent structures. Objective: To establish the accuracy of the injection site into the knee joint in patients with grade II-III gonarthrosis. The portal approaches taken into consideration in this study were: Anterolateral (AL), Anteromedial (AM), Lateral Suprapatellar (LSP), Lateral mid-patellar (LMP), Medial mid-patellar (MMP) and Transtendinous (TT). Methods: A cross-sectional and descriptive study was conducted. A total of 123 knee joints were injected under fluoroscopy through the different approach portals. Variables: gender, positive arthrography at the first attempt, level of pain in patients during the procedure, as well as complications and side effects. Results: Lateral mid-patellar (LMP) approach was used on 20 knee joints with a 40% positive arthrography, 17 through LSP with 70.5%, 20 MMP with 90%, 21 AL with 61.3%, 26 M with 69.9%, 19 TT with 78.9% Conclusion: The medial mid-patellar approach portal provides the greatest effectiveness in comparison to the other portals used on this study. Additionally, a greater percentage of positive arthrography was achieved at the first attempt.

English Abstract

Introducción: La infiltración de la rodilla es una labor cotidiana en la consulta ortopédica. Para alcanzar el mayor potencial terapéutico en la infiltración articular, es necesario inyectar directamente en el espacio articular y no en estructuras adyacentes. Objetivo: Determinar la exactitud y eficacia de los diferentes puntos de infiltración de la rodilla en pacientes con gonartrosis grado II – III, considerando el portal Anterolateral (AL), Anteromedial (AM), Suprapatelar lateral (SPL), medio patelar lateral (MPL), medio patelar medial (MPM) y trans tendón (TT). Material y métodos: Estudio descriptivo y transversal. Se infiltraron 123 rodillas bajo control fluroscópico en las diferentes vías de acceso, teniendo como variables el sexo, artrografía positiva al primer intento, grado de dolor que presentan los pacientes durante la prueba así como complicaciones y efectos secundarios. Resultados: Se usó Medio Patelar lateral (MPL) en 20 rodillas teniendo una artrografía positiva en el 40%, 17 SPL con 70.5%, 20 MPM con 90%, 21 AL rodillas con 61.3%, 26 AM con 69.9%, 19 TT con 78.9%. Conclusión: El portal medio patelar medial proporciona una mayor eficacia a comparación de los otros portales en este estudio. Siendo mayor el porcentaje de artrografías positivas al primer intento de punción.

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