Dalury David F
Towson Orthopaedic Associates, 8322 Bellona Avenue, Suite 100, Towson, MD 21204.
JBJS Essent Surg Tech. 2014 Apr 9;4(2):e7. doi: 10.2106/JBJS.ST.N.00001. eCollection 2014 Jun.
Currently, a popular form of pain control following total knee arthroplasty is the use of periarticular injections; how the medications are injected is a critical step in the efficacy of this modality.
STEP 1 SETUP: The setup includes the injection fluid and two control syringes with a 22-gauge needle.
STEP 2 INJECT THE LATERAL FEMORAL PERIOSTEUM: Inject around the femur before placing the implants.
STEP 3 INJECT THE POSTERIOR ASPECT OF THE CAPSULE: This is another area of rich innervation that needs to be injected carefully.
STEP 4 INJECT THE MEDIAL PERIOSTEUM: Use a similar technique of slow small-volume injections, watching for the periosteal wheal or elevation off the bone.
STEP 5 INJECT THE CAPSULE AND SKIN: Include the lateral gutter and proximal extensor mechanism as well as around the patella, with minimal injection into the skin.
Careful injection technique improves the outcome of periarticular injections for pain control. Indications ContraindicationsPitfalls & Challenges.
目前，全膝关节置换术后一种流行的疼痛控制方式是使用关节周围注射；药物的注射方式是这种治疗方式疗效的关键步骤。
步骤1 准备：准备工作包括注射液和两个配有22号针头的控制注射器。
步骤2 注射股骨外侧骨膜：在植入假体前围绕股骨进行注射。
步骤3 注射关节囊后侧：这是另一个神经丰富的区域，需要小心注射。
步骤4 注射内侧骨膜：采用类似的缓慢小剂量注射技术，注意观察骨膜风疹或骨膜从骨上抬起的情况。
步骤5 注射关节囊和皮肤：包括外侧沟和近端伸肌机制以及髌骨周围，尽量少向皮肤内注射。
仔细的注射技术可改善关节周围注射控制疼痛的效果。适应证 禁忌证 陷阱与挑战。
