To avoid puncture of tendons, blood vessels, and nerves, the clinician performing the procedure should be familiar with the anatomy of the specific joint. The risk of such injuries can be minimized by using the extensor surface of the joint for needle insertion while keeping the joint in minimal flexion.
Zuber TJ. Knee joint aspiration and injection. Am Fam Physician. 2002 Oct 15. 66(8):1497-500, 1503-4, 1507. [Medline]. [Full Text].
Zhang Q, Zhang T, Lv H, Xie L, Wu W, Wu J, et al. Comparison of two positions of knee arthrocentesis: how to obtain complete drainage. Am J Phys Med Rehabil. 2012 Jul. 91(7):611-5. [Medline].
Self WH, Wang EE, Vozenilek JA, del Castillo J, Pettineo C, Benedict L. Dynamic emergency medicine. Arthrocentesis. Acad Emerg Med. 2008 Mar. 15(3):298. [Medline].
Thomsen TW, Shen S, Shaffer RW, Setnik GS. Videos in clinical medicine. Arthrocentesis of the knee. N Engl J Med. 2006 May 11. 354(19):e19. [Medline].
Li SF, Cassidy C, Chang C, Gharib S, Torres J. Diagnostic utility of laboratory tests in septic arthritis. Emerg Med J. 2007 Feb. 24(2):75-7. [Medline].
Anterior view of right knee.
Anatomic landmarks for knee arthrocentesis.
Infiltration of local anesthetic via medial parapatellar approach (left knee).
Left-knee aspiration via medial parapatellar approach.
Application of bandage after left-knee aspiration.
PMN = polymorphonuclear; WBC = white blood cell.