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Objective: To compare the accuracy of blind arthrocenthesis based on anatomic landmarks, and ultrasound (US) guided arthrocentesis of hip joint (HJ). Material and methods: Ninety-six patients with unior bilateral radiologically proven hip osteoarthritis (OA) were included in the study. A total number of 187 hip joints were injected. One blind arthrocentesis by lateral approach was performed on each patient. The accurate position of the needle was verified by a following injection of 0.5-1.0 ml contrast and radiological assessment. After seven days, the same patients (187) underwent a second arthrocentesis under US guidance. Results: Seventy-four percent (97/131) of all blind arthrocentesis in Kellgren-Lawrence (K-L) radiological grade II OA patients were successful, and 26% (34/131) unsuccessful. All US-guided arthrocentesis were successful (131/131). In radiological grade III OA patients successful blind arthrocentesis were performed in 61.3% (19/31) of the patients and unsuccessful in 38.7% (12/31) of the patients. All patients with radiological grade III OA had succesfull US-guided arthrocentesis (31/31). In patients with radiological grade IV OA, successful “blind” arthrocentesis were performed in 40% (10/25) and unsuccessful in 60% (15/25) of the patients. The success rate of US-guided arthrocentesis in the same group was 92% (23/25), while 8% (2/25) of arthrocentesis were unsuccessful. Conclusion: The use of blind lateral approach for arthrocentesis of HJ is not recommended as a routine diagnostic or therapeutic procedute except for some cases with outpatient administration of local anaesthetics, and corticosteroids for temporary pain relieve. The US-guided arthrocentesis of HJ in patients with K-L grade II-III of OA reaches 100% accuracy. In K-L grade IV OA patients, presence of hip joint contracture and obesity could influence significantly the accuracy of arthrocentesis.

Study on Accuracy of Blind and Ultrasound-Guided Arthrocentesis of Hip Joint