How painful is a knee puncture? | Knee puncture

How painful is a knee puncture?

Knee joint puncture is almost painless and is described as hardly more painful than a blood draw. For this reason, local anesthesia is generally not used, as the puncture is about as painful as the puncture itself. If desired, however, local anesthesia can be performed under certain circumstances.

When inserting medication or contrast medium, a non-painful feeling of pressure may occur under certain circumstances. If there was swelling due to an effusion, the puncture can even relieve the pressure and thus reduce the pain. Since no general anesthesia is necessary due to the painlessness, the procedure can also be performed on an outpatient basis.

Performing the puncture

The knee joint puncture can be performed on an outpatient basis, which means that no hospital stay is necessary. The knee must be kept free of clothing. As a rule, it is not necessary to shave the knee before the procedure, as this may even encourage infections.

However, if hair on the knee is obstructed, it can be slightly shortened with scissors. The knee is disinfected before the puncture. A brown iodine solution is often used for this purpose.

The knee is usually stored in an extended position. The muscles should be completely relaxed. Only in the ventral access route, which is often used to introduce medication into the joint space, does the patient sit at the edge of the examination couch and let the leg hang down loosely.

The knee is bent. After disinfection, the hollow needle is inserted into the joint space under sterile conditions. This means that only equipment that has been thoroughly disinfected is used.

Under certain circumstances, it may be necessary to visualize the joint with an ultrasound device beforehand in order to locate it correctly. Depending on the problem, the doctor will then either inject the medication or aspirate the joint fluid. This is then examined in a laboratory for inflammatory cells, blood, antibodies, proteins or other changes.

If symptoms occur after the injection, the doctor who performed the puncture beforehand or another doctor should be consulted.The knee joint puncture is usually performed on an outpatient basis and does not take very long. If it is only an injection of medication or a reduction of little joint fluid, the puncture only takes a few minutes. If a bruise is aspirated, the process may take a little longer.

It is recommended to keep the knee still for about four to six hours after the puncture. However, please ask your treating physician for more detailed information. There are several suitable access routes for knee joint puncture.

Typical are: In the lateral approach, the knee is in an extended position. The kneecap is lifted slightly and the knee is punctured from the side below the kneecap. A lateral-proximal access route is particularly suitable for large joint effusions.

In this approach, the puncture is made about 1.5 cm laterally above the patella. If the puncture is to be used for injection, the ventral access is usually used. With this access route, the patient sits optimally on the edge of the couch and allows the leg to hang freely. The puncture is made in the middle of an imaginary triangle, the corners of which are formed by the patellar tendon, the articular process of the thigh lying towards the middle of the body and the upper surface of the tibia.

  • The lateral one,
  • The lateral-proximal
  • Or the ventral access.