Korean J Pain.  2020 Jul;33(3):258-266. 10.3344/kjp.2020.33.3.258.

Comparing the effectiveness of ultrasound guided versus blind 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

• Cankurtaran D
• Karaahmet OZ
• Yildiz SY
• Eksioglu E
• Dulgeroglu D
• Unlu E

• KMID: 2504071
• DOI: http://doi.org/10.3344/kjp.2020.33.3.258

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. USguided injections may yield more effective clinical results than blind injections.

Keyword

Knee Joint; Muscle Strength; Nerve Block; Osteoarthritis, Knee; Pain Management; Quality of Life; Steroids; Treatment Outcome; Ultrasonography, Interventional

Figure

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  Fig. 1 The lines were used for blind injection. Blind injection was applied at superolateral, superomedial and inferomedial corners of the lines.

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  Fig. 2 (A) Changes of visual analogue scale (VAS), Western Ontario and McMaster’s Universities Osteoarthritis Index (WOMAC) and Nottingham Health Profile (NHP) during three months in ultrasound-guided injection genicular nerve block (GNB) group. (B) Changes of VAS, WOMAC and NHP during three months in blind injection GNB group.

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  Fig. 3 Changes of isokinetic test results during three months within groups. PT: peak torque.

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