Joint Injection Protocol: A Comprehensive Guide for Orthopedic Practitioners

Pre-Procedure Assessment

Patient Evaluation

• Review patient history and contraindications
• Verify injection site and indication
• Check for allergies to injectable medications
• Review recent imaging studies
• Obtain informed consent

Equipment Preparation

• Sterile gloves
• Antiseptic solution (chlorhexidine or betadine)
• Sterile drape
• Local anesthetic (1% lidocaine)
• Injectable medication (corticosteroid/viscosupplementation)
• Needle and syringe appropriate for target joint
• Sterile gauze and bandage

Procedure Steps

1. Site Preparation

1. Position patient appropriately for target joint
2. Mark anatomical landmarks
3. Perform sterile prep of injection site
4. Apply sterile drape

2. Injection Technique

1. Administer local anesthetic if needed
2. Insert needle using proper approach for specific joint
3. Aspirate to confirm proper placement
4. Inject medication slowly
5. Apply pressure after withdrawal

3. Post-Procedure Care

• Apply sterile dressing
• Provide post-injection instructions
• Document procedure details
• Schedule follow-up as needed

Joint-Specific Considerations

Knee Joint

• Approach: Lateral or medial patellofemoral
• Needle size: 18-22G
• Volume: 5-10mL maximum

Shoulder Joint

• Approach: Anterior or posterior
• Needle size: 20-22G
• Volume: 4-8mL maximum

Hip Joint

• Approach: Anterior under fluoroscopic guidance
• Needle size: 20-22G
• Volume: 6-8mL maximum

Complications and Management

Immediate

• Pain at injection site
• Bleeding
• Vasovagal reaction

Delayed

• Infection
• Post-injection flare
• Skin changes

Documentation Requirements

• Indication for procedure
• Informed consent
• Technique used
• Medication and dose
• Post-procedure status
• Follow-up plan