Consent Requirements for Knee Arthrocentesis
Informed consent (either written or verbal) is required for knee arthrocentesis, and it must be obtained and documented according to local institutional policies, with the key requirement being that the patient is fully informed about the procedure's nature, benefits, and risks. 1
Form of Consent: Written vs. Verbal
The 2021 EULAR guidelines explicitly state that whether informed consent should be oral or written is determined by local institutional habits and regulations, as there was no preferred option identified in their patient survey. 1 The critical element is not the format but rather that:
- The patient must be fully informed of the nature of the procedure, the injectable substance being used, and potential benefits and risks 1
- Consent must be obtained and documented according to your institution's standard practices 1
- The documentation should reflect the shared decision-making process that occurred 1
Essential Information to Provide
Regardless of whether you use written or verbal consent, you must communicate: 1
- The nature of the arthrocentesis procedure itself
- The potential benefits (pain relief, diagnostic information, improved range of motion)
- Side effects and risks (including the 2.6% risk of vasovagal reactions) 1
- Post-procedure care instructions
Emergency Situations
In emergency circumstances where full written consent is not feasible, verbal consent is acceptable but must be fully documented in the medical record. 1 If the patient lacks capacity and verbal consent cannot be obtained in an emergency, the action taken must be the least restrictive of the patient's future options. 1
Practical Implementation
The consent process should occur with sufficient time for the patient to consider the information, not immediately before the procedure when the patient may feel vulnerable. 1 For outpatient procedures, providing written information in advance allows patients time to read, evaluate, and formulate questions. 1
Common Pitfall to Avoid
Do not obtain consent for the first time in the procedure room or immediately before needle insertion—this does not allow adequate time for informed decision-making and may render the consent invalid. 1 The consent discussion should ideally occur during the clinical encounter when arthrocentesis is first recommended, with confirmation on the day of the procedure. 1
Documentation Requirements
Whatever form of consent you use, your documentation must include: 1
- That the patient was informed about the procedure's nature, benefits, and risks
- That the patient had opportunity to ask questions
- That the patient's concerns were addressed
- The patient's decision to proceed (or decline)
In summary: Both written and verbal consent are acceptable for knee arthrocentesis—follow your local institutional policy, but always ensure the patient is adequately informed and the consent process is properly documented.