Performing an Intrameniscal Injection Introduction The menisci are two wedge-shaped fibrocartilaginous structures that are located between the tibia and femur that act as a support structure for the knee.
Anatomy of the meniscus Due to the load across the meniscus with ambulation, they are susceptible to degeneration and tears over time. Degenerative meniscus tears are found in 35% of knees of patients aged 70-90 years old. Treatment of a degenerative meniscus tear can range from physical therapy, injection, and arthroscopic surgery.
The primary goal in treatment of a meniscus tear is to preserve meniscus cartilage, as arthroscopic removal of meniscus tissue can lead to knee osteoarthritis. MRI showing horizontal posterior horn medial meniscus tear Historically, corticosteroid injections are injected into the joint to treat symptoms associated with arthritis and degenerative meniscus tear. However, due to persistent pain in some patients after these injections, intra-meniscal injections have been studied.
Studies have found improvements in patient’s functional outcomes and pain levels with a PRP injection into a chronic meniscus tear. Other studies have looked at corticosteroid injections into the perimeniscal tissue, which have also been found to lead to pain improvement. Meniscus tear is the white arrow Procedure A linear transducer is typically used for an intrameniscal injection.
The patient will be placed in a side-lying position with the affected side facing upwards. For optimal positioning, the knee will be flexed to 30 to 60 degrees and a rolled-up towel can add valgus or varus stress depending on tear location. Providers will typically use a 25g needle for anesthesia.
Providers should first evaluate for the presence of the saphenous nerve medially and the common fibular nerve laterally. Position of probe in long axis Then, with the probe in long axis to the knee, a short axis view of the meniscus is seen. A protruding meniscus will appear to bulge over the bone.
If you are experiencing symptoms that may be related to intrameniscal injection techniques, it is important to see a sports medicine physician. Early evaluation and treatment typically lead to better outcomes. Do not ignore pain or symptoms that are limiting your activity.
*This article is for educational purposes only and does not substitute for professional medical advice. Always consult a qualified healthcare provider.*
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