Therapeutic Genicular Nerve Block for Chronic Pain Management in Patients with Knee Osteoarthritis

Abstract

Background: Therapeutic genicular nerve block (TGNB) is both an effective and safe treatment procedure for pain related to chronic osteoarthritis of the knee (OA). It is most common amongst the elderly. It is characterized by joint stiffness, pain and disability. Aim: The aim of this study was to examine the analgesic and functional impact of ultrasound-guided TGNB in patients with chronic knee OA and to evaluate the efficacy of local anesthetics and corticosteroids. Patients and methods: The study included 20 patients. Pain was assessed according to the numerical pain scale (NRS), and improvement of the functional capacity was assessed according to the WOMAC Index (Western Ontario and McMaster Universities Osteoarthritis Index). SLGN, SMGN and IMGN were identified, and 3 mL of a mixture of local anesthetic (ropivacaine 0.75%) and corticosteroid (triamcinolone 40 mg) were applied to each nerve. Results: The average NRS value before TGNB was 5.1, and the WOMAC score was 58.55. After the TGNB was performed, NRS was 2.4 (47% decrease in pain intensity) and WOMAC was 30.1 (51% decrease in the intensity of ailment). Conclusion: TGNB is effective and not harmful in treating pain and enhances the functional capacity in patients with knee OA. The clinical benefits of corticosteroid administration suggest that it may be an appropriate adjuvant in TGNB for knee OA.

Keywords

• chronic pain, knee osteoarthritis
• genicular nerves
• ultrasound
• therapeutic genicular nerve block
• NRS
• WOMAC index