Blind versus Guided Injections

As biologics like PRP and stem cells have become more popular over the years, more health care providers are offering them in their clinics. Many factors go into how effective the treatment will be, and one of those is how the product is injected into the area. The two ways to inject a joint are either doing it blind or using imaging guidance.

At Bennett Orthopedics and Sportsmedicine, all injections are done with guidance from an ultrasound machine. Ultrasound can visualize tendon, ligament and fascial tearing and can see even partial tears of tissue. Specifically, for the knee, it can evaluate the meniscus for tears. It is also useful for isolating the best way to get the needle into the joint and avoid the bone area of the knee. The ultrasound is capable of seeing the needle as well for injecting areas.

Why can’t you just go by an MRI or x-ray picture and anatomical palpations? Often an MRI and x-ray are enough for diagnostic purposes. However, the ultrasound is often used prior to an MRI at the time of the initial evaluation in order to confirm a diagnosis that may be made from performing a physical exam. It is especially important to use guided injections for PRP and stem cells because the cells must be placed in the tear area or the tissue will not heal.

A study done in 2011 tested the effectiveness of blind injections vs guided ones. The outcome was overwhelmingly pro guided injections. Forty-eight percent reduction in procedural pain, forty-two percent reduction in pain scores at outcome, 107% increase in responder rate, and thirteen percent reduction in cost per patient per year[i].

Call 941-953-5509 to schedule a consultation with Dr. Bennett and see your joint through our ultrasound machine.

[i] “A randomized controlled trial evaluating the cost-effectiveness of sonographic guidance for intra-articular injection of the osteoarthritic knee.” Department of Internal Medicine, University of New Mexico Health Sciences Center, Albuqerque, NM USA. Journal of Clinical Rheumatology. (8) 409-15. 2011 Dec 17. Viewed 2017 August 25.

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