This study explores a new posterior approach for intra-articular hip injections, particularly suited for patients where the traditional anterior approach may pose challenges. The primary goal was to examine the methodology, accuracy, and potential adverse events associated with this posterior technique. The study included ten adult patients, each referred for hip injection due to hip osteoarthritis or femoral acetabular impingement with labral tearing. Patients were positioned prone, and ultrasound guidance with a curvilinear transducer was used to visualize posterior hip structures. A 22-gauge spinal needle was directed in-plane towards the hip capsule at the femoral head-neck junction, advancing from an inferolateral to superomedial orientation. Needle placement accuracy was then confirmed through fluoroscopic arthrography.
The findings revealed that, in nine out of ten patients (90%), accurate needle placement was achieved on the first attempt. Only one patient required a conversion to the anterior approach due to challenges in obtaining the expected arthrogram. Mild adverse events were observed in two patients (20%), but no serious complications were noted, highlighting the safety of this approach. These results suggest that the ultrasound-guided posterior approach to hip injections is both effective and safe, offering an alternative for patients who may not be suitable candidates for anterior access. This pilot study supports the posterior approach as a viable option, potentially broadening procedural choices for clinicians in complex cases.
