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Knee puncture is a minimally invasive surgical procedure consisting in inserting a sterile needle into the joint cavity and collecting the accumulating fluid for examination. What are the indications and contraindications for knee puncture? What is the puncture of the knee joint and what are the complications?

Knee joint puncture(popularlyknee puncture ) is a diagnostic and therapeutic procedure, i.e. it is used both to diagnose ailments in the musculoskeletal system as well as for their pharmacological therapy.

Puncture of the knee joint is performed on an outpatient basis and is associated with a small number of complications, therefore it is a frequently used procedure in the diagnosis and treatment of pain in the area of ​​the knee joint.

Knee puncture: indications

Puncture of the knee joint is a diagnostic and therapeutic procedure. It is most often performed in patients who complain of pain in the area of ​​the knee joint, which intensifies during walking and significantly interferes with daily functioning, in order to determine the probable cause and initiate appropriate pharmacotherapy.

Puncture of the joint cavity and removal of the accumulated fluid causes a drop in pressure inside the joint, thus reducing the pain. Increased production and retention of fluid in the joint cavity occurs after a knee joint injury and the onset of infection within it.

It may also be the result of the intensification of inflammatory and degenerative changes in the course of chronic joint diseases, which include, among others, gout and rheumatoid arthritis.

The fluid collected during the puncture should be subjected to biochemical and bacteriological analysis in a medical laboratory, as well as microscopic examination, in order to determine the probable cause of its excessive production and retention in the joint cavity.

It is also worth noting that doctors often decide to perform a puncture of the knee joint simultaneously with intra-articular administration of drugs. Typically these are local anesthetics, non-steroidal anti-inflammatory drugs, glucocorticosteroids, or hyaluronic acid.

They are designed to reduce pain, swelling and inflammation, and in the case of acidhyaluronic acid - support the reconstruction of articular cartilage.

Knee joint puncture: contraindications

Puncture of the joint cavity is not performed in patients with purulent lesions on the skin of the injection area, because there is a risk of bacterial transmission and infection of the physiologically sterile joint.

In addition, the procedure should be avoided in people with blood coagulation disorders, suffering from bleeding disorders or taking chronic medications that reduce blood clotting, without prior blood laboratory tests.

In these patients, before puncture of the joint cavity, it is recommended to determine the blood coagulation parameters - prothrombin time (i.e. PT) and koalin-kephalin time (i.e. APTT), as well as the number of platelets.

Before starting the procedure, inform the doctor about any possible allergies to drugs, both local anesthetics and glucocorticosteroids and non-steroidal anti-inflammatory drugs, which, when administered into the joint cavity, may cause an allergic reaction in people who are hypersensitive to their effects.

Knee joint puncture: preparation for the procedure

A patient qualified for the knee puncture procedure does not have to prepare for it in a special way. However, you should, if possible, avoid forcing the limb and performing strenuous physical exercises a few days before the doctor's appointment.

Knee puncture: course

The knee joint puncture procedure is performed on an outpatient basis and does not require hospitalization. The patient is asked to lie on his back on a medical couch, and the doctor (usually an orthopedic specialist) palpates the knee joint and determines where the needle is inserted.

After thoroughly disinfecting the skin and applying local anesthesia, under sterile conditions, inserts a sterile needle into the joint cavity. By pulling the syringe plunger, it takes the synovial fluid, which is then sent for examination.

If the doctor deems it necessary to administer topical medications, he may now introduce them into the joint cavity. Most often they are local anesthetics, painkillers, glucocorticosteroids or agents that improve the condition and support the reconstruction of articular cartilage, such as hyaluronic acid.

Drugs administered directly into the joint are intended to reduce pain, swelling and inflammation. After removing the needle, cover the injection site with a sterile dressing. Knee joint puncture is a minimally invasive and low painful procedure.

After its execution it is not necessary to immobilize the limb, it should behowever, use common sense and do not overstress the limb for the first few days after the procedure.

Knee puncture: complications

Complications after a correctly performed knee joint puncture are rare. The most frequently observed side effects include joint infection, which may be manifested by an increase in pain in the area of ​​the treated knee.

The knee area is painful on palpation, it is swollen, warm, and the skin around the joint is often red.

In the event of additional fever and chills, contact your GP as soon as possible, because the appearance of general symptoms may indicate the development of a serious infection and requires further diagnosis with blood laboratory tests, as well as proper antibiotic therapy.

Less common complications of knee puncture include damage to the articular cartilage, as well as internal bleeding into the joint cavity, caused by accidental puncture of a blood vessel.

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