Pain Perception During Intra-Articular Knee Joint Injection: What is the Effect of Needle Gauge and the Use of Ethyl Chloride?
University of California, Davis
Summary
This study aims to investigate factors that affect the subjective experience of pain during and after intra-articular knee joint injection of steroids by comparing needle gauge size (22 G vs 25 G needles), as well as the presence or absence of topical ethyl chloride spray. Additionally, this study will investigate the effects of other various factors on patients' pain associated with the injection. Lastly, this study aims to determine the effect of patients' subjective pain from the injection on long-term clinical outcomes. Specific aims are as follows: Aim 1): Determine the effect of needle gauge size on patient reported pain associated with an ultrasound-guided intra-articular knee injection. Aim 2): Determine the effect of ethyl chloride spray on patient reported pain associated with an ultrasound-guided intra-articular knee injection. Aim 3): Determine the effect of sex, age, BMI, thigh size, severity of OA, and fear of needles on patient pain associated with an ultrasound-guided intra-articular knee injection. Aim 4) Determine the effect of patient pain from the procedure on longer term clinical outcomes after an ultrasound-guided intra-articular knee steroid injection. Researchers will obtain data at various time points, including pre-procedural data, immediately after the procedure, 24-48 hours after, and 6 weeks post-procedure. Participants will: Consent to receiving an intra-articular knee joint injection with steroids if indicated. Score their "procedural" pain immediately following the procedure, score their post-procedural "soreness" 24-48 hours after via telephone call, and score their overall knee pain about 6 weeks after the procedure via telephone call.
Description
Hypotheses to be tested: Hypothesis 1): Patients who receive an ultrasound-guided intra-articular knee steroid injection with a 25G needle will report less pain from the procedure at the time of the procedure and less procedure-related pain 24-48 hours after the procedure Hypothesis 2) Patients who receive an ultrasound-guided intra-articular knee steroid injection with use of ethyl chloride with a given needle gauge will report less pain from the procedure at the time of the procedure and 24-48 hours after the procedure Hypothesis 3) Higher thigh circumference and fear of needles will be a…
Eligibility
- Age range
- 40–89 years
- Sex
- All
- Healthy volunteers
- Yes
Inclusion Criteria: 1. age ≥ 40 years 2. fulfillment of the American College of Rheumatology criteria for knee OA 3. confirmation of knee-related pain and/or functional loss by clinical examination. 4. Patients with either 1. bilateral knee OA/injections, or 2. unilateral knee OA/injections. 5. Agreed to an intra-articular knee joint injection with steroids 6. Naive to use of ethyl chloride Exclusion Criteria: 1. Arthroscopy of the index knee(s) within the prior 6 months 2. Steroid injection of the knee(s) within the prior 3 months 3. Hyaluronic acid or platelet-rich plasma injection…
Interventions
- Procedure25 gauge needle
This intervention will observe patients post-procedural pain using a 25 gauge needle
- Procedure22 gauge needle
This intervention will observe patients post-procedural pain using a 22 gauge needle
- Procedure+/- Ethyl Chloride Topical Aerosol Anesthetic
This intervention will observe patients post-procedural pain when using topical ethyl chloride spray. This will be compared to a placebo spray which will utilize isopropyl alcohol.
Location
- UC Davis Sports Medicine ClinicSacramento, California