IRCCS Istituto Ortopedico Galeazzi, Via Riccardo Galeazzi 4, 20161, Milan, Italy.
Dipartimento Di Scienze Biomediche Per La Salute, Università Degli Studi Di Milano, Milan, Italy.
Eur Radiol. 2022 Mar;32(3):1438-1447. doi: 10.1007/s00330-021-08258-1. Epub 2021 Sep 14.
Interventional procedures around the knee are widely adopted for treating different musculoskeletal conditions. A panel of experts from the Ultrasound and Interventional Subcommittees of the European Society of Musculoskeletal Radiology (ESSR) reviewed the existing literature to assess the evidence on image-guided musculoskeletal interventional procedures around the knee, with the goal of highlighting some controversies associated with these procedures, specifically the role of imaging guidance, as well as the efficacy of the medications routinely injected.
We report the results of a Delphi-based consensus of 53 experts in musculoskeletal radiology, who reviewed the published literature for evidence on image-guided interventional procedures around the knee to derive a list of pertinent clinical indications.
A list of 10 statements about clinical indications of image-guided procedures around the knee was created by a Delphi-based consensus. Only two of them had the highest level of evidence; all of them received 100% consensus.
Ultrasonography guidance is strongly recommended for intra-articular and patellar tendinopathy procedures to ensure the precision and efficacy of these treatments. Prospective randomized studies remain warranted to better understand the role of imaging guidance and assess some of the medications used for interventional procedures around the knee.
• A list of 10 evidence-based statements on clinical indications of image-guided interventional procedures around the knee was produced by an expert panel of the ESSR. • Strong consensus with 100% agreement was obtained for all statements. • Two statements reached the highest level of evidence, allowing us to strongly recommend the use of ultrasonography to guide intra-articular and patellar tendon procedures to ensure higher accuracy and efficacy of these treatments.
膝关节周围的介入性操作广泛应用于治疗各种肌肉骨骼疾病。欧洲肌肉骨骼放射学会（ESSR）的超声和介入小组委员会的一组专家对现有文献进行了回顾，以评估膝关节周围影像引导肌肉骨骼介入性操作的证据，旨在强调与这些操作相关的一些争议，特别是影像学引导的作用，以及常规注射药物的疗效。
我们报告了对 53 名肌肉骨骼放射学专家进行基于 Delphi 的共识的结果，这些专家对膝关节周围影像引导介入性操作的已发表文献进行了回顾，以确定一系列相关的临床适应证。
通过基于 Delphi 的共识，创建了一份关于膝关节周围影像引导性操作的 10 项临床适应证的声明清单。只有其中两项具有最高水平的证据；它们都获得了 100%的共识。
强烈推荐超声引导用于关节内和髌腱病变的操作，以确保这些治疗的准确性和疗效。仍需要前瞻性随机研究来更好地了解影像学引导的作用，并评估用于膝关节周围介入性操作的一些药物。
• ESSR 专家组制定了一份关于膝关节周围影像引导介入性操作的 10 项基于证据的临床适应证声明清单。
• 所有声明均获得 100%的共识。
• 有两项声明达到了最高水平的证据，使我们能够强烈推荐使用超声引导来指导关节内和髌腱的操作，以确保这些治疗的更高准确性和疗效。
