title: Sonographically Guided Anterior Cruciate Ligament Injection: Technique and Validation.
abstract: OBJECTIVE
  To describe and validate a practical technique for sonographically guided anterior cruciate ligament (ACL) injections.
  
  
  METHODS
  Prospective, cadaveric laboratory investigation.
  
  
  METHODS
  Procedural skills laboratory in a tertiary medical center.
  
  
  METHODS
  Ten unembalmed, cadaveric mid-thigh-knee-ankle foot specimens (5 left knees and 5 right knees; 5 male and 5 female) from 10 donors aged 76 to 93 years (mean 85.6 years) with body mass indices of 17.6 to 42.2 kg/m(2) (mean 28.8 kg/m(2)).
  
  
  METHODS
  A single, experienced operator used a 22-gauge, 63.5-mm stainless steel needle and a 12-3-MHz linear transducer to inject 1.5 mL of diluted colored latex into the ACLs of 10 unembalmed cadaveric specimens via an in-plane, caudad-to-cephalad approach, long axis to the ACL. At a minimum of 24 hours postinjection, specimens were dissected, and the presence and distribution of latex within the ACL assessed by a study co-investigator.
  
  
  RESULTS
  Presence and distribution of latex within the ACL.
  
  
  RESULTS
  All 10 injections accurately delivered latex into the proximal (femoral), midsubstance, and distal (tibial) portions of the ACL. No specimens exhibited evidence of needle injury or latex infiltration with respect to the menisci, hyaline cartilage, or posterior cruciate ligament.
  
  
  CONCLUSIONS
  Sonographically guided intra-ligamentous ACL injections are technically feasible and can be performed with a high degree of accuracy. Sonographically guided ACL injections could be considered for research and clinical purposes to directly deliver injectable agents into the healing ACL postinjury or postreconstruction.
authors: Department of Physical Medicine & Rehabilitation, Mayo Clinic, W14, Mayo Building, 200 1st St, SW, Rochester, MN 55905; and Departments of Radiology and Anatomy, Mayo Clinic College of Medicine, Mayo Clinic, Rochester, MN.
authors: Jay
authors: J
authors: Smith
authors: The Andrews Institute, Gulf Breeze, FL.
authors: Joshua G
authors: JG
authors: Hackel
authors: Regenerative Orthopedic and Sports Medicine Institute, Bowling Green, KY.
authors: Umar
authors: U
authors: Khan
authors: Department of Anatomy, Mayo Clinic College of Medicine, Mayo Clinic, Rochester, MN.
authors: Wojciech
authors: W
authors: Pawlina
authors: Department of Physical Medicine & Rehabilitation, Mayo Clinic Sports Medicine Center, Mayo Clinic, Rochester, MN.
authors: Jacob L
authors: JL
authors: Sellon
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016118:Anterior Cruciate Ligament / Q000000981:diagnostic imaging*; D000070598:Anterior Cruciate Ligament Injuries; D002102:Cadaver; D005260:Female; D006801:Humans; D007270:Injections, Intra-Articular / Q000379:methods; D007718:Knee Injuries / Q000000981:diagnostic imaging / Q000188:drug therapy*; D007840:Latex / Q000008:administration & dosage*; D008297:Male; D011446:Prospective Studies; D015203:Reproducibility of Results; D018084:Ultrasonography, Interventional / Q000379:methods*
chemical_list: D007840:Latex