Name:
Knee Joint Aspiration or Arthrocentesis for Septic Knee
Description:
Knee Joint Aspiration or Arthrocentesis for Septic Knee
Thumbnail URL:
https://cadmoremediastorage.blob.core.windows.net/e412d75d-cf6f-465c-b03e-e11dacd41cb8/videoscrubberimages/Scrubber_1.jpg
Duration:
T00H05M00S
Embed URL:
https://stream.cadmore.media/player/e412d75d-cf6f-465c-b03e-e11dacd41cb8
Content URL:
https://cadmoreoriginalmedia.blob.core.windows.net/e412d75d-cf6f-465c-b03e-e11dacd41cb8/Knee Joint Aspiration or Arthrocentesis for Septic Knee.mp4?sv=2019-02-02&sr=c&sig=%2BtFB9%2FPUrQGDnmz0vNfuVJGa5VSk9N1Ar1zKxMvcGDM%3D&st=2024-11-21T14%3A00%3A20Z&se=2024-11-21T16%3A05%3A20Z&sp=r
Upload Date:
2024-05-31T00:00:00.0000000
Transcript:
Language: EN.
Segment:0 .
Hello viewers, today I'm going to show you a technique as how to aspirate a knee. Now, knee aspiration is extremely common procedure done in outpatients clinic. Now, the technique I'm going to show you is a technique which in my experience, is less painful than a conventional technique. Now, today we are aspirating a 35-year-old lady's knee, who is come with a painful knee with increased temperature.
And I'm suspecting that she has septic arthritis. So whenever you aspirating a knee, there are always more than one approaches. I've uploaded a video in which I have shown you how to do a knee injection and I find that less painful. Same approach can be used for aspiration as well. So you can go anterior medially you can go anterior laterally. But most times when people aspirate the aim to get the needle in between the patellofemoral joint.
Now this joint, if the effusion is small or if somebody has got degenerative changes in this joint, the space between patella and the front of the femur can be quite small. And if you are trying to negotiate your needle in that space, inevitably a lot of times you will hit either femur or you will hit the patella, and that can be quite painful to the patient. So the technique that I use is I try not to enter the patellofemoral joint.
So I try that my needle stays on top of the patella. No so that is where I will try to enter. So I will not aim to go into the joint, but I will go parallel and I will show you when I'm doing my aspiration. So that I don't hit any bone. And this is much easier way to get into the joint. So if you look from the front and I will demonstrate it once again, you aim to go a centimeter up and down. So that you are up the patella and down, so that you approach laterally, so that you don't come into this joint and that will make your aspiration of going into the joint much easier and much less painful.
So when you're aspirating a knee, it is extremely critical that you do it under clean atmosphere. I try to do it in theatre because I don't want to be accidentally introducing an infection if the knee is not infected. So I have cleaned it with alcohol and I play it with a sterile drape. So first thing I do is I feel for the Super lateral aspect of the patella because that is a key landmark.
As I said in my presentation, I don't want to be entering into the patellofemoral joint. So once you have felt the Super lateral aspect of the patella, you aim to go a centimeter up in this direction. And if I show it with a needle a centimeter up and down this way, you are staying on top of the patella. And you are nowhere close to the patellofemoral joint and then stay in this direction and you will enter the joint. Now, the other important thing is when you are thinking that there is an infection, the infectious collection is usually turbid and thick.
So it's important that you use a wide bow needle. On this occasion, I'm using a size 16 gauge needle so that I don't have any difficulty in aspirating a thick fluid. Now, some people will give local anesthetic in order to make this procedure less painful. However, giving a local anesthetic itself can be quite painful, so I try not to do it. So again, all I feel is that this is the landmark in which I want to go in.
So I'm going to stay at 90 degree and I'll go not in this direction, but straight across and staying on top of the patella. So sharp scratch. You want the patient. Sharp scratch. Staying straight on top of the patella. You go and enter into the joint. So you are in, you slowly aspirate and you should have at least 20 mil because most of the times you will aspirate a lot of fluid, especially if the swelling is so bad.
So once you aspirate, you need to see what you have aspirated. On this occasion we have aspirated around 70 mL of Frank pus. Most of the times you will have a clear yellow fluid that is usually reactive effusion. In fracture cases, you may find blood and you may find some fat globules. So if you are aspirating, you cannot make it pain free. You will have some amount of pain.
But if you want to make it less painful, don't aim to go in between patella. And the trochlea, because if you hit the bone, it will make it more painful. So I am just above the patella and I'm going horizontally parallel to the floor. I'm not going in this direction. I'm not going in this direction. I'm just going straight up.
And as you go and enter this.....[VIDEO ENDS]
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