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Mcclean et al: Accuracy and safety of two landmark‐guided techniques for arthrocentesis and intra‐articular injection of the shoulder in dogs
Veterinary Surgery 4, 2025

🔍 Key Findings

  • Study Type: Cadaveric study using 36 paired canine shoulders (n = 18 per group: Subacromial [SA] and Supratubercular [ST])
  • Survey Results: 75% of clinicians preferred SA technique; 25% used ST
Accuracy Outcomes:
  • Complete accuracy: 50% (SA), 44% (ST) — no significant difference (p = .8)
  • Partial accuracy: 39% (SA), 50% (ST)
  • Complete miss: 11% (SA), 5.6% (ST)
Safety Outcomes (India Ink Assay for Iatrogenic Articular Cartilage Injury [IACI]):
  • Incidence of IACI:
    • SA: 50% (9/18 shoulders)
    • ST: 11% (2/18 shoulders) → statistically significant (p = .007)
  • Lesion depth: All ST lesions were partial-thickness; SA group had one full-thickness lesion (p = .027)
  • Location: Lesions found on glenoid and humeral head with even distribution in SA; only one each in ST
Clinical Implications:
  • Landmark-guided injections were ≤50% completely accurate, even by an experienced operator.
  • ST technique is safer with lower risk of cartilage damage, despite similar accuracy.
  • Findings support considering image-guided techniques to improve both safety and accuracy in clinical settings.

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← Articles

Mcclean et al: Accuracy and safety of two landmark‐guided techniques for arthrocentesis and intra‐articular injection of the shoulder in dogs
Veterinary Surgery 4, 2025

🔍 Key Findings

  • Study Type: Cadaveric study using 36 paired canine shoulders (n = 18 per group: Subacromial [SA] and Supratubercular [ST])
  • Survey Results: 75% of clinicians preferred SA technique; 25% used ST
Accuracy Outcomes:
  • Complete accuracy: 50% (SA), 44% (ST) — no significant difference (p = .8)
  • Partial accuracy: 39% (SA), 50% (ST)
  • Complete miss: 11% (SA), 5.6% (ST)
Safety Outcomes (India Ink Assay for Iatrogenic Articular Cartilage Injury [IACI]):
  • Incidence of IACI:
    • SA: 50% (9/18 shoulders)
    • ST: 11% (2/18 shoulders) → statistically significant (p = .007)
  • Lesion depth: All ST lesions were partial-thickness; SA group had one full-thickness lesion (p = .027)
  • Location: Lesions found on glenoid and humeral head with even distribution in SA; only one each in ST
Clinical Implications:
  • Landmark-guided injections were ≤50% completely accurate, even by an experienced operator.
  • ST technique is safer with lower risk of cartilage damage, despite similar accuracy.
  • Findings support considering image-guided techniques to improve both safety and accuracy in clinical settings.

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Multiple Choice Questions on this study

In McClean 2025 et al., on shoulder arthrocentesis techniques, what recommendation did the authors make based on safety and accuracy data?

A. Favor subacromial approach for all injections
B. Use blind injections only in emergencies
C. Always avoid fenestration
D. Prefer image guidance to improve safety and accuracy
E. Shorten needle length for all techniques

Answer: Prefer image guidance to improve safety and accuracy

Explanation: Less than 50% accuracy and significant cartilage injury prompted authors to recommend image-guided injections.
In McClean 2025 et al., on shoulder arthrocentesis techniques, what percentage of injections using the subacromial (SA) approach were completely accurate?

A. 28%
B. 39%
C. 44%
D. 50%
E. 61%

Answer: 50%

Explanation: SA injections were completely accurate in 50% of shoulders.
In McClean 2025 et al., on shoulder arthrocentesis techniques, which of the following best summarizes the accuracy comparison between SA and ST techniques?

A. SA was significantly more accurate
B. ST was significantly more accurate
C. Both were equally inaccurate
D. No significant difference in accuracy
E. ST had double the accuracy

Answer: No significant difference in accuracy

Explanation: SA was 50% accurate; ST was 44% — not statistically different (p = .8).
In McClean 2025 et al., on shoulder arthrocentesis techniques, which technique showed a significantly lower rate of iatrogenic cartilage injury?

A. Subacromial (SA) approach
B. Supratubercular (ST) approach
C. Both had equal risk
D. Neither caused injury
E. Image-guided injection

Answer: Supratubercular (ST) approach

Explanation: ST injections had a significantly lower IACI rate (11% vs 50%, p = .007).
In McClean 2025 et al., on shoulder arthrocentesis techniques, what proportion of SA injections resulted in cartilage injury (IACI)?

A. 11%
B. 22%
C. 33%
D. 44%
E. 50%

Answer: 50%

Explanation: Half of the SA injections resulted in iatrogenic cartilage injury.

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