Evidence map›Paper›PMID 29292479›Full record

ArticleLa Radiologia medica2018

Learning curves of two different techniques for the intra-articular injection of the knee joint under fluoroscopic guidance.

Paolo Simoni, Olivier Malaise, Mounia El Hachemi, Angelo Tromba, Grammatina Boitsios

Erratum issuedAbstract readComparative Study
PubMed Publisher
In one paragraph

Article in La Radiologia medica, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. EULAR recommendations for intra-articular therapies.Annals of the rheumatic diseases · 2021
    Guideline
  2. Review
  3. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

5 authors.

Paolo Simoni"Reine Fabiola" Children's University Hospital, Université Libre de Bruxelles (ULB), 15, Avenue Jean Joseph Crocq, 1020, Brussels, Belgium. paoloemiliosimoni@gmail.com.
Olivier MalaiseRheumatology Department, CHU de Liège, CHU du Sart Tilman, Bât. 35, 4000, Liège, Belgium.
Mounia El HachemiRadiology Department, CHU de Liège, CHU du Sart Tilman, Bât. 35, 4000, Liège, Belgium.
Angelo TrombaRadiology Department, CHU de Liège, CHU du Sart Tilman, Bât. 35, 4000, Liège, Belgium.
Grammatina Boitsios"Reine Fabiola" Children's University Hospital, Université Libre de Bruxelles (ULB), 15, Avenue Jean Joseph Crocq, 1020, Brussels, Belgium.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimThe aim of the study was to compare the learning curves of three beginner operators using two different techniques of intra-articular injection of the knee under fluoroscopic guidance with a superolateral approach. MATERIALS AND

methodsIn total, 177 consecutive patients (72 females (40.7%) and 105 males (59.3%), mean age 42.2 ± 15.0 years) scheduled for a computed tomography (CT) arthrography and without joint effusion on the lateral X-rays were enrolled. They underwent an intra-articular injection of the knee under fluoroscopic guidance with a superolateral approach. Patients were randomly assigned to three different operators, including a junior supervisor and two first-year residents in radiology who never performed an intra-articular injection of the knee before the present study. Procedures in lateral or supine position were randomly assigned to three operators.

resultsThere was a higher rate of successful injections with the lateral position (92.1%) than with supine position (80.2%) (odds ratio (OR) 4.52, 95% confidence interval (CI) 1.46-14.0). A significant learning effect was observed for the supine position, while none was observed for the lateral position. Pain and time of fluoroscopy did not differ between the two procedures (p = 0.85 and p = 0.10, respectively). Junior supervisor had a higher rate of successful intra-articular injection compared with the other two operators (p = 0.0072). There was a statistically significant higher rate of extravasation with the supine position (66.3%) than with lateral position (19.7%) (p < 0.0001, OR 0.13, 95% CI 0.06-0.25).

conclusionThe intra-articular injection of the knee under fluoroscopic guidance with the patient in lateral position is an easy technique for operators in training with a low rate of extravasation. Lateral position does not require a supplementary irradiation and does not increase the procedural pain. Personal operator's skill is an independent factor in determining the success of the training.

Indexed as

Clinical CompetenceLearning CurveAdultFemaleFluoroscopyHumansInjections, Intra-ArticularKnee JointMalePatient PositioningRadiology, InterventionalReproducibility of ResultsArthrographyFluoroscopyHumansInjections, intra-articular/methodsKneeReproducibility of results interventional

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.