Article Text

A randomised controlled trial of the reciprocating syringe in arthrocentesis
  1. H T Draeger,
  2. J M Twining,
  3. C R Johnson,
  4. S C Kettwich,
  5. L G Kettwich,
  6. A D Bankhurst
  1. University of New Mexico, Albuquerque, New Mexico, USA
  1. Correspondence to:
    Dr H T Draeger
    Department of Internal Medicine, 5th floor ACC, University of New Mexico Health Sciences Center, Albuquerque, NM 87131, USA; hdraeger31{at}


Objective: To evaluate the outcomes of arthrocentesis with the new highly controllable, one handed reciprocating procedure syringe compared with a conventional syringe.

Methods: 100 arthrocentesis procedures were randomised between the reciprocating syringe and the conventional syringe. Outcome measures included patient pain, procedure duration, operator satisfaction, synovial fluid volume, cell counts, and complications.

Results: 50 arthrocentesis procedures with the conventional syringe resulted in a mean (SD) procedure time of 3.39 (1.88) minutes, a mean VAPS (patient pain) score of 5.35 (3.15), and a mean VASS (operator satisfaction) score of 4.88 (1.92); 30 of the 50 subjects experienced moderate to severe pain (VAPS score 5 or greater) during arthrocentesis. In contrast, the reciprocating syringe resulted in a reduced procedure time of 1.94 (1.14) minutes (p<0.001), a reduced VAPS (patient pain) score of 2.54 (1.60) (p<0.001), and an increased VASS (operator satisfaction) score of 8.91 (0.79) (p<0.001). Only five of the 50 of subjects experienced moderate to severe pain with the reciprocating syringe. Synovial cell counts were similar between the two syringes (p>0.05), but there was a trend toward greater volume (greater synovial fluid yield) and fewer red blood cells with the reciprocating syringe.

Conclusions: Arthrocentesis with a conventional syringe results in moderate to severe pain in 60% of subjects. The reciprocating syringe prevents significant pain, reduces procedure time, and improves physician performance of arthrocentesis. The reciprocating syringe is superior to the conventional syringe in arthrocentesis.

  • VAPS, visual analogue scale, pain
  • VASS, visual analogue scale, operator satisfaction
  • syringe
  • joint procedure
  • arthrocentesis
  • reciprocating
  • injection

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  • Published Online First 8 December 2004

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