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At the site of maximal tenderness
1%
23/2485
Medial to patellar tendon with knee flexed
6%
152/2485
Lateral to patellar tendon with knee flexed
17%
429/2485
Medial to proximal patella with knee in extension
4%
98/2485
Lateral to the patella with knee in extension
71%
1770/2485
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Intra-articular administration of medications has been shown to be highest with the injection performed lateral to the middle to proximal patella with the knee in extension. Extension allows greater patellar mobility and increases the available space in the patellofemoral joint compared to flexion. A lateral starting point when injecting into the patellofemoral joint has less overlying soft tissue than medial, which makes it easier to palpate the bony landmarks and evert the patella. Jackson et al. evaluated 240 consecutive injections in patients without clinical knee effusion placed anteromedial, anterolateral, or lateral midpatellar. Using fluoroscopy to confirm location, accuracy rates were highest for the midlateral portal (93%) compared to anteromedial (75%) or anterolateral (71%).
2.9
(33)
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