The process of using a needle and syringe to remove fluid from a joint, called arthrocentesis or joint aspiration, has a short recovery time. While it is considered a generally safe, low-risk procedure, problems can arise.

This page describes what expect during arthrocentesis recovery as well as potential risks and complications, including when to call a doctor.

Bursal aspiration recovery, risks, and complications

Many of the concepts covered on this page also apply to bursal aspirations. A bursal aspiration is done when bursitis causes a bursa to fill with excess fluid. Like arthrocentesis, a bursal aspiration is a low-risk procedure from which most people recover quickly. Health care providers can advise individual patients based on their specific procedures and unique health circumstances.

See What Is Bursitis?

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Arthrocentesis Recovery

While some patients may resume activities immediately after arthrocentesis, others may be told to rest the affected joint from anywhere between 4 to 24 hours. These patients may be required to have another person drive them home following the procedure.

Local anesthetics, such as lidocaine, typically wear off in 2 to 4 hours,1 so patients may feel an increase in pain shortly after leaving the doctor’s office. It is common to have mild soreness for a day or two after the procedure.

Patients should ask their doctors whether it is okay to take nonsteroidal anti-inflammatory drugs (NSAIDs) or other over-the-counter pain medications. Depending on the circumstances, the doctor may recommend periodically icing the affected joint and wrapping it in a bandage to prevent re-swelling.

Arthrocentesis Risks and Complications

The most common side effect associated with arthrocentesis is temporary joint discomfort. Other less common risks include2:

  • The needle may scrape or puncture the joint’s cartilage.
  • The skin may become discolored because of bleeding under the skin.
  • Excess blood may enter the joint capsule.
  • The patient may have an allergic reaction to the anesthetic.
  • The needle puncture can introduce blood or infection into the joint capsule. Experts suggest infection occurs in less than 0.01% of patients who undergo joint injections.2
  • The skin may react to the antiseptics used to clean the skin or the adhesive bandage applied after the procedure.

In addition to these risks, patients should keep in mind that it is common for fluid to reaccumulate and swelling to return after a joint aspiration.3

When to contact a doctor

Serious complications after arthrocentesis are rare. Call a physician or other health care provider immediately if any of the following occur:

  • Moderate to extreme re-swelling
  • Discoloration or rash around the injection area
  • Fever
  • Bleeding or discharge from the needle’s entry point
  • Moderate to severe pain—mild pain and soreness is normal, but pain that is not adequately controlled with over-the-counter pain medication and ice packs should be reported
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For most patients, arthrocentesis is a safe and uneventful procedure. It is a fast and cost-effective way to obtain joint fluid for diagnostic evaluation and treat swelling. Similarly, aspirating fluid from a bursa is a widely accepted way to diagnose or rule out a suspected bursal infection and treat bursitis.

References

  • 1.Courtney P, Doherty M. Joint aspiration and injection and synovial fluid analysis. Best Practice & Research Clinical Rheumatology, Volume 27, Issue 2, April 2013, Pages 137-169, ISSN 1521-6942, http://dx.doi.org/10.1016/j.berh.2013.02.005
  • 2.Zuber TJ. Knee joint aspiration and injection. Am Fam Physician. 2002 Oct 15;66(8):1497-500, 1503-4, 1507. PubMed PMID: 12408424.
  • 3.Seidman AJ, Limaiem F. Synovial Fluid Analysis. [Updated 2019 Jan 22]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK537114/
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