Are There Any Risks Associated With Knee Aspiration
While complications due to knee aspiration are less likely, there are some risks associated with any procedure. Some risks that may be involved with knee aspiration include discomfort and pain at the local site, sometimes swelling or bruising may be seen, rarely an infection can develop at the aspiration site or within the joint.
In order to avoid such complications, proper physician training is ensured and appropriate preventive measures are implemented.
How Are Arthrocentesis And Joint Injections Performed
Joint aspirations and injections take place in your healthcare providers office. Your provider may use images from an ultrasound or X-rays to guide procedures.
First, your provider disinfects the skin. For smaller joints, your provider applies a numbing cream to the skin. You may need a local anesthetic to numb a bigger joint section like the hips or shoulders.
During joint aspiration and injection, your provider:
When To Consider Knee Drainage
Knee swelling can be a painful, functionally debilitating condition and should not be ignored. Many cases of knee swelling can be resolved with rest, ice, physical therapy, and anti-inflammatory medication. However, if the swelling begins to restrict movement or becomes increasingly painful, you may be eligible for knee drainage.
Knee drainage can both diagnose the source of swelling and provide effective pain relief and improved mobility. Moreover, it is a simple in-office procedure requiring very little downtime. If you are experiencing pain and swelling in your knee, drainage may be the most effective option to get you back to performing your daily activities pain-free.
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What Is Knee Joint Aspiration And Injection
Joint aspiration and injection refer to the placement of a needle into a joint cavity to remove fluid for analysis or study, and to inject medicine for pain relief or treatment of a disease . Sometimes the doctor may only remove some of the joint fluid to establish a diagnosis for the collection of fluid. In other cases, such as in patients with chronic osteoarthritis, the doctor may only inject medicine to provide pain relief.
Knee Infection After Surgery
Knee replacement surgery is a common surgery that doesnt present complications for most people. In less than 1 percent of joint replacement surgeries, an infection occurs around the area of the artificial implant. However, as joint replacements are on the rise, so is the rate of infection.
Since artificial joints are made of metal and plastic, they dont have any sort of immune capability to fight off harmful bacteria. Artificial joints can become infected at the time of your surgery, or even years after your surgery.
Surgeries performed to repair torn cartilage or tendons can also introduce bacteria to the knee joint. ACL repair and meniscus repair are among the common knee surgeries that can result in an infection.
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Indications Of Knee Aspiration For Therapeutic Purposes Include
- Relieving Tense Effusion When knee swelling is large or tense or pain causes discomfort, drainage of fluid helps to relieve the pressure and pain.2 Reduction in swelling and decreased tension aids in improving joint movement.
- Drainage of Infected Fluid In a known infective condition, drainage of septic effusion can help in providing relief, improve joint movement and prevent damage to the joint.
- Injection of Medications into the Knee Joint Knee aspiration and injection is at times performed to provide relief in joint conditions.3
When Should I Call The Doctor
- Allergic reaction, such as worsening pain or difficulty breathing.
- Signs of infection, such as redness, heat or swelling at the treatment site.
- Worsening pain at the treatment site.
A note from Cleveland Clinic
Joint aspiration can help your healthcare provider determine the cause of joint inflammation and pain. The procedure is also therapeutic. When combined with joint injections, you may get temporary symptom relief. Talk with your provider about whether these treatments are a good option for you.
Last reviewed by a Cleveland Clinic medical professional on 01/23/2021.
- American Academy of Orthopaedic Surgeons. Viscosupplementation. Accessed 2/5/2021.
- American College of Rheumatology. Joint Injections . Accessed 2/5/2021.
- InformedHealth.org. Joint Aspiration. Accessed 2/5/2021.
- National Health Service . Hydrocortisone Injections. Accessed 2/5/2021.
- Zuber TJ. Knee Joint Aspiration and Injection. American Family Physician. 2002 66:1497-1501.Accessed 2/5/2021.
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Treatment For Fluid In Knees
As with any injury, it’s important to consult your doctor for the appropriate treatment for your situation. Here are some treatments and pain management options you may expect for fluid on the knee:
Aspiration – Your doctor may drain the knee to relieve the pressure of the knee fluid. If blood is present, then it is often sent to the lab to analyze the fluid to ensure that infection is not present. The knee may continue to fill with fluid after being aspirated.
PRICE Method – If knee trauma or injury is the cause of the knee fluid, then your doctor may recommend that you use the PRICE method of Protection, Rest, Ice, Compression and Elevation. The combination of these is often used as first aid treatment to minimize fluid in the knee after a traumatic injury.
Medications – There are different types of medications that may be used to treat the excess of knee fluid, depending on the cause of the issue. For example:
- Over-the-counter medications – Pain medications such as ibuprofen or aspirin may be used to help reduce inflammation
- Steroids – These may be taken orally or injected directly into the knee joint. This may be used if over-the-counter medications are not effective at reducing pain.
- Antibiotics – If your knee fluid is caused by infection, then antibiotics may be necessary to fight the bacteria
How Is Joint Aspiration Performed
The skin over the joint is cleaned by the health care professional using a liquid, typically an iodine solution . A local anesthetic is used in the area of the joint either by injection, a topical liquid coolant, or both. A needle with a syringe attached is inserted within the joint and joint fluid is drawn back under suction into the syringe. For certain diseases and medical conditions, the health care professional will also inject medicine into the joint after fluid removal. The needle is then removed and a Band-Aid or dressing is applied over the entry point.
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Warnings And Common Errors
Carefully ensure optimal positioning before joint puncture.
Allow adequate time for local anesthesia to take effect before proceeding.
To avoid damaging the synovium and articular cartilage, do not advance the needle against resistance and do not move the needle once it has begun draining synovial fluid.
If the needle tip must be relocated, first withdraw it almost to the skin surface and then redirect do not try to change the angle of insertion while a needle is embedded in tissue.
Distinguish a knee effusion from effusion or swelling of the prepatellar bursa.
How Do I Get Ready For A Joint Aspiration
Your healthcare provider will explain the procedure to you and offer you the chance to ask any questions that you might have about the procedure.
You will be asked to sign a consent form that gives your permission to do the procedure. Read the form carefully and ask questions if something is not clear.
Tell your healthcare provider if you are sensitive to or are allergic to any medicines, latex, tape, and anesthetic agents .
Tell your healthcare provider of all medicines and herbal supplements that you are taking.
Tell your healthcare provider if you have a history of bleeding disorders or if you are taking any anticoagulant medicines, aspirin, or other medicines that affect blood clotting. It may be necessary for you to stop these medicines before the procedure.
If you are pregnant or suspect that you are pregnant, you should notify your healthcare provider.
Generally, no prior preparation, such as fasting or sedation is needed.
Based on your medical condition, your healthcare provider may request other specific preparation.
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How Can I Prevent Fluid On The Knee
One of the best ways to prevent this condition is to take care of your joints. Maintain a healthy weight, practice exercises to keep the surrounding muscles strong, flexible, and supportive.
Consider low-impact activities such as cycling, swimming, or moderately challenging walking avoid steep hills. Make sure you use the correct form with any exercises to protect your knees and other joints.
Who Performs A Joint Aspiration
Joint aspirations can be performed under medical guidelines by qualified doctors, including general physicians, internists, orthopedic surgeons, rheumatologists, interventional radiologists, emergency room physicians, as well as nurse practitioners and physician assistants.
Medical complications of joint aspiration are uncommon. Possible complications of the aspiration procedure include a reaction to the local anesthetic, local bruising or, minor bleeding into the joint. If cortisone is used, there may be loss of pigment in the skin . A rare but serious complication of the procedure is infection of the joint .
With corticosteroid injections, additional uncommon complications include inflammation in the joint as a result of the medication crystallizing, shrinkage or loss of pigment of skin at the injection site, increased blood sugar , and aggravation of preexisting infection elsewhere in the body. If multiple injections with corticosteroids are given too frequently, it is possible to develop systemic side effects , such as weight gain, puffy face and trunk, and easy bruising. Injection of hyaluronic acid derivatives may cause local inflammation and swelling of the joint due to a reaction to the medication. Hyaluronic acid injections into the knee joint for pain relief are generally given no more frequently than every six months.
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Knee Aspiration: Everything You Need To Know
The knee can get affected in injuries, joint conditions or systemic illnesses, leading to pain and swelling of the knee joint. Knee swelling is mainly accumulation of fluid in or around the joint. Knee effusion or water on knee commonly occurs due to acute trauma, arthritis and other forms of joint disorders or infection.
In such situations, knee joint aspiration, also known as arthrocentesis is performed for aspiration of excess fluid. It can be performed as a diagnostic as well as treatment modality.1
What Is A Joint Aspiration
Joint aspiration is a procedure whereby a sterile needle and syringe are used to drain synovial fluid from a patient’s joint. Joint aspiration is typically performed by a doctor or ancillary health care provider as an office procedure or at the bedside of hospitalized patients. Joint aspiration is sometimes called joint drainage and is medically referred to as arthrocentesis.
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Treatments For Swollen Knee
Your treatment will depend on whats causing your swollen knee and how painful it is. Your doctor will recommend the most appropriate treatment after diagnosing the underlying cause.
In most cases, youll be advised to take painkillers. You can also apply ice and elevate your knee to help reduce the swelling. Sometimes removing some of the fluid in your knee helps reduce the pain and stiffness.
Other treatments include:
Draining A Bakers Cyst Is A Fast Option For Relieving The Pain And Discomfort In The Back Of Your Knee
Draining a Bakers Cyst is a fast option for relieving the pain and discomfort in the back of your knee. The following is a video of a medical doctor draining a Bakers Cyst from the back of a mans left leg.
Be prepared! This is not for queasy stomachs
Remember this in only one solution for draining a Bakers Cyst from the back of your leg. There are other natural approaches that dont involve drugs or needles for draining a Bakers Cyst from the back of your leg.
Its important to understand that your body has the capacity for draining the Bakers Cyst on its own. If your body is NOT doing so then we must start asking deeper questions as to why the Bakers Cyst is not draining by itself.
The majority of the time its due to tension that builds up in the leg which doesnt allow for the lymphatic fluid to move freely throughout the body. By freeing up this tension in back of the leg this starts the process by which your body can drain the Bakers Cyst by itself without any medical intervention.
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How Is The Procedure Performed
Your doctor will wash the skin over the joint with an antibacterial solution and then select the easiest and safest method of entry into the joint. Although the skin over the joint can be numbed, the injection of the numbing medicine often hurts more than the needle insertion itself. The needle is inserted carefully into the joint, and fluid may be withdrawn. Without having to perform an additional needle-stick, the syringe holding the fluid can be removed, and a syringe containing the medicine is placed on the needle. The medicine is inserted quickly, and the needle is removed.
Causes Of Swollen Knee
If your pain and swelling have come on suddenly, it may be due to an injury from playing sport or after an accident or fall. Common injuries include:
- A fracture
- Taking nonsteroidal anti-inflammatory drugs eg ibuprofen to relieve your pain
Chronic swelling, often with night-time pain, could be due to an underlying disease. These conditions, such as arthritis, are more likely as you age.
If you have arthritis, you will have chronic inflammation but you may also have symptoms of acute inflammation. There are different types of arthritis, which can all cause a swollen knee. These include:
- Gout caused by too much uric acid in your blood
- Infectious arthritis caused by an infection of a joint that leads to swelling
- Juvenile arthritis occurs in people aged up to 16 years
- Osteoarthritis the most common form of arthritis caused by break-down of cartilage in the joints
- Reactive arthritis usually occurs after an infection of your genitals or urinary tract and becomes chronic this is not common
- Rheumatoid arthritis your immune system mistakenly attacks your joints
If your doctor thinks your swollen knee could be caused by arthritis, they will ask you about any other symptoms and your medical history. They may refer you for further investigations, such as blood tests or an X-ray.
Treatments for arthritis vary depending on the type you have. They include:
- Lifestyle changes eg exercise
- Self-help devices eg easy-grip utensils, jar openers and reachers
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Your Swollen Joint Is Stiff And Painful
Arthritis and other joint problems can lead to swelling that causes or worsens pain and stiffness. You may notice that its difficult to bend or completely straighten the swollen joint. Removing some of the joint fluid can relieve pressure and ease your symptoms.
Its common for swelling to return after a joint aspiration,1 and a joint may be aspirated more than once.
What Is Knee Aspiration And Injection
Knee aspiration and injection is introduction of medications into the joint space following fluid aspiration. Medications like steroids, antibiotics or other medications may be instilled into the knee joint depending on the cause and severity of the condition.
Local steroid injection can provide considerable relief, reduce discomfort and is often found helpful in acute exacerbations of chronic joint conditions that cause large knee effusion. Sometimes, after the injection, the joint may get inflamed for which appropriate treatment is given.
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Is There Anything Else I Need To Know About A Synovial Fluid Analysis
Arthrocentesis, the procedure used to do a synovial fluid analysis, may also be done to remove excess fluid from a joint. Normally, there is only a small amount of synovial fluid between the joints. If you have a joint problem, extra fluid can build up, causing pain, stiffness, and inflammation. This procedure can help relieve pain and other symptoms.
Arthrocentesis Of The Knee
The knee and connecting suprapatellar pouch can be punctured while the patient is supine and the knee is extended. The needle, 18- or 20-gauge, can be inserted anteromedially, under the cephalad half or third of the patella. Alternatively, the needle can be inserted laterally, just under the cephalad edge of the patella .
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What Is The Purpose Of Joint Aspiration And When Is It Performed
Joint aspiration can be both used for diagnosis and medical treatment of arthritis of a joint. Joint aspiration is used to obtain fluid from the patient’s joint for examination in the laboratory. Analysis of joint fluid can help the physician to define causes of joint swelling or arthritis, such as infection, gout arthritis, and rheumatoid disease. Fluid from the joint can be tested for white cell count, crystals, protein, glucose, as well as cultured to detect infection. Each of these laboratory parameters can be helpful in defining the cause of a particular form of arthritis, particularly in distinguishing inflammatory from non-inflammatory forms of arthritis. The result can be key to identifying various potential rheumatology diseases and musculoskeletal conditions.
Joint aspiration can also be a helpful treatment in relieving joint swelling and pain. Removal of synovial fluid from the joint that is inflamed can also remove the white blood cells within that are sources of enzymes that can be destructive to the joint. This treatment can more rapidly restore the health of the joint. Bursa aspiration procedure and indications for bursitis are analogous to joint aspiration for arthritis, except the bursa is the target instead of the joint . The result and analysis of the fluid is similarly evaluated for various diseases and conditions in the laboratory.