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Procedure for administering DUROLANE

The Knee

The knee should be prepared in the usual way for an intra articular injection. The procedure should be undertaken with full no touch aseptic technique.

You will need:

• A treatment couch
• Isopropyl alcohol based skin preparation or spirit based iodine skin prep.
• Sterile gloves
• Sterile drape for under the knee
• A 21g or 19g needle. If the patient has a high BMI then a spinal needle may be required.
• Local anaesthetic for the skin
• Small wound dressing
• Post injection advice leaflet for the patient

It is advisable to use a sterile procedure pack which will contain a galipot, swabs, forceps, and a 10ml aspiration syringe.

Due to increased inaccuracy associated with anterior approaches to the knee joint it is recommended using a lateral or medial mid patella approach to injecting the knee with the leg extended.

If there is a block to full extension then a small support can be placed under the popliteal fossa.

If local anaesthetic is used it is recommended using a small amount to the skin only. Feedback from the patient during the procedure is a good indicator of correct intra-articular placement and local anaesthetic can mask the discomfort that can be immediately felt if the DUROLANE is injected into the soft tissues around the joint.

If significant pain or swelling around the joint is noted during injection the possibility of extra articular injection should be considered and the needle replaced into the joint space.

The knee should always be aspirated prior to injecting DUROLANE.

If the knee joint is dry then it is advisable to confirm the presence of the needle in the intra articular space by injecting some sterile saline and then aspirating it back.

As with all intra articular HA injections it is critical to the efficacy of the treatment that the DUROLANE is injected into the joint space. It is therefore recommended that rigorous attention to technique is paid to ensure this.

The whole 3mls of DUROLANE should be injected into the knee joint.

Post treatment advice is offered, which patients should follow in order to optimise the benefits of DUROLANE treatment.

Please contact us to request a procedure DVD.

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