Anterolateral hip injection approach under portable ultrasound guidance: a prospective randomized controlled trial versus conventional ultrasound.

Purpose: This study aimed to evaluate an innovative anterolateral approach using portable ultrasound, comparing the accuracy and safety of portable ultrasound-guided, conventional ultrasound-guided, and landmark-based blind injection techniques.

Methods: In this single-centre, prospective, randomised controlled trial, 117 patients with hip pain were randomly assigned to three groups: landmark-based blind injection (n = 39), conventional ultrasound-guided injection (n = 39), and portable ultrasound-guided injection (n = 39). Each patient received a unilateral injection of 2.5 ml hyaluronic acid and 1 ml betamethasone via the anterolateral approach, using parameters optimized from previous research. Primary endpoints included success and accuracy rates, while secondary endpoints comprised post-injection visual analogue scale (VAS) pain scores, procedure time, puncture depth, and complications.

Results: The portable ultrasound group achieved 100% success and accuracy rates, comparable to the conventional ultrasound group, whereas the blind group showed lower success (87.2%) and accuracy (79.4%) rates. Post-injection VAS pain scores were significantly lower in the portable ultrasound group (1.95, SD 0.99) compared with the blind group (2.95, SD 1.61; p = 0.007) and similar to those in the conventional ultrasound group (2.41, SD 1.27; p = 0.337). Procedure times were comparable across all groups, and no significant differences in puncture depth were observed. Importantly, no injection-related complications were reported.

Conclusion: Portable ultrasound-guided injections via the anterolateral approach demonstrate accuracy and safety comparable to conventional ultrasound-guided injections. Additionally, the portable device offers advantages in portability, reduced space requirements, and cost-effectiveness, thereby enhancing clinical utility in outpatient settings.