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. 2022 Jan;41(1):217-224.
doi: 10.1002/jum.15700. Epub 2021 Mar 31.

Ultrasound-Guided Perimeniscal Injections: Anatomical Description and Feasibility Study

Clemence Coll  1 , Jean-Marie Coudreuse  1 , Daphne Guenoun  2   3 , Laurent Bensoussan  1 , Jean-Michel Viton  1 , Pierre Champsaur  2   3 , Thomas Le Corroller  2   3
Affiliations
Free article

Ultrasound-Guided Perimeniscal Injections: Anatomical Description and Feasibility Study

Clemence Coll et al. J Ultrasound Med. 2022 Jan.
Free article

Abstract

Objectives: To anatomically describe the ultrasound (US)-guided perimeniscal injection technique, and evaluate its feasibility in the treatment of meniscal pain.

Methods: This work was initially undertaken in four cadaveric specimens with US-guided medial and lateral perimeniscal injection of China ink, followed by cadaveric dissection to assess injectate distribution, and potential injury to intra-articular and peri-articular structures. Then, 35 consecutive patients who underwent US-guided perimeniscal corticosteroid injection under local anesthesia for the treatment of symptomatic medial (30/35) or lateral (5/35) degenerative meniscal tear were retrospectively evaluated. Clinical outcome was assessed using a 0-10 numerical verbal rating scale (VRS) to evaluate severity of pain before, during, and after procedure at 6 weeks follow-up.

Results: Seven of eight (87.5%) ex vivo injections were accurate. A single inaccurate medial perimeniscal injection infiltrated the tibial collateral ligament instead of the perimeniscal area. No anatomical specimen exhibited intrameniscal injection or injury to regional structures. All procedures (35/35) performed clinically were technically successful. Median VRS scores were: 7 (range, 3-9) before procedure, 5 (range, 0-10) during procedure, and 1.5 (range, 0-9) after procedure at 6 weeks follow-up (P <.0001). No complication was observed.

Conclusions: US-guided perimeniscal injections can accurately and safely deliver injectates in the perimeniscal area. In addition, our data suggest that perimeniscal corticosteroid injection provides significant symptom relief at 6 weeks in patients with meniscal pain. Further studies with long-term follow-up will be required to evaluate the role of perimeniscal injections in the nonoperative management of meniscal pathology.

Keywords: anatomy; knee; meniscus; ultrasound.

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