Comparing the effectiveness of ultrasound guidedversusblind genicular nerve block on pain, muscle strength with isokinetic device, physical function and quality of life in chronic knee osteoarthritis: a prospective randomized controlled study

Abstract

Background The genicular nerve block (GNB) is demonstrated from several reports to alleviate pain and improve knee functionality in patients with chronic knee osteoarthritis (OA). Ultrasound (US)-guided GNB has been the most used imaging method. This study aimed to compare the effectiveness of US-guided versus blind GNB in the treatment of knee OA. Methods This prospective, randomized clinical trial included patients with knee OA based on American College of Rheumatology diagnostic criteria. The patients were evaluated for clinical and dynamometer parameters at the baseline, 4 weeks after treatment, and 12 weeks after treatment. The patients underwent blind injection or US-guided injection. Results When compared with the baseline, both groups showed significant improvement in pain, physical function, and quality of life parameters. Significant differences were observed between the groups for clinical parameters (30-second chair stand test, 6-minute walk test) in favor of the US-guided group. On the other hand, blind injection was more significantly effective on some parameters of the Nottingham Health Profile. There wasn’t any significant improvement in isokinetic muscle strength for either group. Conclusions This study demonstrated that both US-guided and blind GNB, in the treatment of knee OA, were effective in reducing symptoms and improving physical function. GNB wasn’t an effective treatment for isokinetic muscle function. US-guided injections may yield more effective clinical results than blind injections.

Ultrasound-guided genicular nerve block versus physical therapy for chronic knee osteoarthritis: a prospective randomised study

“…On the other hand, ultrasound-guided GNB is an emerging treatment option that aims to control pain by inhibiting knee innervation. A recent study comparing ultrasound-guided versus blinded GNB injections revealed the superiority of ultrasoundguided injections in improving the functionality in KOA patients [25]. Thus, our functional improvement findings can also be attributed to precision attained by the ultrasound-guided administration of the anaesthetic solution.…”

Value of imaging to guide interventional procedures in rheumatic and musculoskeletal diseases: a systematic literature review informing EULAR points to consider

“…In another study, it was observed that patients with knee osteoarthritis and US-guided injection had a worse quality of life at 3 months than patients with palpation-guided injections, while walking and standing tests were better in the former than in the latter group. 55 All four studies comparing US and fluoroscopy guidance of intervention revealed no difference concerning the nine efficacy outcomes assessed (six outcomes with moderate, three with high RoB). 12 13 15 16 In contrast, one study comparing US or fluoroscopy versus palpationguided injections reported a higher patient satisfaction and patients' judgement of treatment efficacy in the US/ fluoroscopy as compared with the palpation group.…”

Intra-articular corticosteroid injection and genicular nerve block under ultrasound guidance in pain control of knee osteoarthritis

“…GNB is a relatively novel technique developed to relieve chronic OA related pains with reported high efficacy [20]. Ultrasound guided GNB showed more effective clinical results when compared to blind injections in a randomized clinical trial of 40 patients [12]. Furthermore, Kim et al [13] compared the efficacy of GNB when performed with ultrasound and with fluoroscopy in a series of 61 patients.…”

“…Egyptian Journal of Radiology and Nuclear Medicine improve functional capacity mainly on short term bases as evidenced by many studies [9][10][11]. Genicular nerve block (GNB) has recently emerged as an alternative technique with very promising results to reduce OA related pains and improve functional status as evidenced by many recent studies [1,12,13]. It's based on the fact that genicular nerves are accompanied with genicular arteries, which can be easily identified at certain anatomical land marks using ultrasound and confirmed with color Doppler [1].…”