The Development of a One-Handed Knee Aspiration Mechanism to Aid in Arthrocentesis ; A Duty Ethics Analysis on InSite, the First Medically Supervised Safer Injection Facility in North America

Annen, Victoria, School of Engineering and Applied Science, University of Virginia
Laugelli, Benjamin, EN-Engineering and Society, University of Virginia
Miller, Mark, MD-ORTP Sports Med, University of Virginia
Backlund, Ian, Interns And Resident, University of Virginia

One-Handed Knee Aspiration Mechanism and Medically Supervised Safer Injection Facilities
In its most literal sense, the syringe is the primary connection between my technical work and my STS research. Syringes are used in various medical procedures, including vaccinations, biopsies, and fluid aspirations. My technical work aims to develop a device that allows for one-handed syringe retraction. The device not only enhances physician comfort and ease of use, but it also seeks to improve the effectiveness and healing time of knee arthrocentesis, a procedure where excess fluid is removed from a patient’s knee joint. On the other hand, syringes are also used for illicit drug use and can result in dire health issues, especially when used incorrectly or without proper sanitation. My STS research discusses the ethicality of medically supervised safer injection facilities (SIFs), which provide sterilized equipment and education for injection drug users in order to minimize dangerous consequences of drug abuse. While both projects analyze
the use of the syringe to improve health, they take vastly different approaches to do so.
Knee arthrocentesis is a common surgical procedure for individuals with osteoarthritis, a form of arthritis that affects the joints. In the procedure, the physician extracts excess fluid from the knee joint in order to relieve pain and swelling. Arthrocentesis is most effective when the physician can use one hand to retract the syringe and the other to massage the knee, which directs the fluid towards the needle. However, uncomfortable hand positioning and high force requirements of syringes make one-handed retraction unstable and uncomfortable for the physician. The one-handed knee aspiration mechanism developed in my technical project wraps around the syringe and uses a purely mechanical design to retract the plunger. The device is not only more comfortable than a standard syringe, but it also frees up the physician’s other hand to massage the knee and extract as much fluid as possible. In addition, it places the physician’s hand closer to the needle for added stability, which minimizes tissue damage.
My STS research also focuses on syringes but highlights the risks they have on injection drug users. Individuals who use illicit drugs are often uneducated in proper injection methods and reuse of syringes and needles. Although not legal in many countries, SIFs offer a safe space and sterile equipment to drug users. In addition, medical personnel are present on site to provide emergency care and educate individuals on safer injections. Existing facilities have shown that this intervention has led to safer injections with a decrease in fatal overdoses, HIV transmissions, and public drug use. My paper claims that while SIFs violate societal norms and legal principles, they are ethical according to two derivatives of duty ethics. My research discusses the morality of actions taken at these facilities in order to prompt debate on public health.
Working on these two projects generated new ideas that added value and interest to both. My technical work provided an understanding of the drawbacks of standard syringes, which gave me background for common issues faced not only by physicians, but also by injection drug users. Similarly, my STS research on SIFs emphasized the importance of safe and effective syringe use, which is imperative in clinical settings. Working on these projects in tandem helped me analyze syringes from medical, legal, and ethical viewpoints, giving me a versatile understanding of their impacts. This not only motivated me to design an effective device that can be used in clinical settings, but it also pushed me to explore the intricacies of syringes in non-medical settings and how this connects to public health.

BS (Bachelor of Science)
Arthrocentesis, One-Handed Knee Aspiration Mechanism, Medically Supervised Safer Injection Facility, InSite

School of Engineering and Applied Science
Bachelor of Science in Biomedical Engineering
Technical Advisor: Mark Miller, Ian Backlund
STS Advisor: Benjamin Laugelli
Technical Team Members: Victoria Annen, Brian Rothemich, Emma Woessner

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