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In general, joint aspiration is a safe procedure. Complications include:
Introducing an infection into a previously sterile joint is the major complication of arthrocentesis (3). The overall risk of infection is approximately one to two infections per 25,000 arthrocenteses performed, and staph. aureus is the most common causative organism(1,3). Risk factors include inattention to sterile technique, introduction of a needle through an area of infection (i.e. cellulitis), or presence of a systemic infection. There is typically no need to give antibiotics prophylactically following joint aspiration. (14).
Tendon injury or rupture, and nerve or blood vessel damage secondary to improper needle placement have been reported (3).
Patients often complain of pain during the procedure. This is often a result of the needle contacting the highly innervated cartilaginous surfaces of the joint. The physician should pull back or redirect the needle if this occurs.
This may be seen after the aspiration of any joint. Placing an elastic wrap around the joint immediately after the procedure may restrict further fluid accumulation.
It has been reported that as many as 1% of knees undergoing repeated steroid injections subsequently develop joint instability secondary to osteonecrosis of adjacent bone and weakening of capsular ligaments. Consequently, injections should not be performed more than once every six to eight weeks and no more than three times per year in weight-bearing joints (8).
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