Effect of Genicular Nerve Block on Proprioception in Knee Osteoarthritis

Ankara City Hospital

Status: Enrolling

Conditions: Osteoarthritis

Treatments: Other: Exercise; Other: genicular nerve block

Study type: Interventional

Funder types: Other

Identifiers

NCT06744842

ANKARA-PMR-BEYZA-01

Details and patient eligibility

About

The study was conducted to investigate the effect of genicular nerve block on pain, quality of life, and proprioception, which are already diminished due to the impact of osteoarthritis in individuals with knee osteoarthritis.

Does genicular nerve block reduce pain and improve the quality of life in patients with knee osteoarthritis? Does genicular nerve block affect proprioception in patients with knee osteoarthritis?

Full description

Osteoarthritis (OA) is described as a degenerative joint disease characterized by cartilage erosion, osteophytes, subchondral sclerosis, and changes in the joint capsule, commonly observed in the elderly. Knee osteoarthritis is identified as the most prevalent form, with an increasing prevalence attributed to aging. It is recognized as a leading cause of disability, resulting in reduced quality of life and increased healthcare costs. Major risk factors include age, genetics, obesity, and muscle weakness. Current treatments focus on symptom management, with options including medication, physical therapy, and surgery.

Genicular nerve block is a minimally invasive procedure used to manage knee osteoarthritis pain by administering local anesthetics and corticosteroids near specific genicular nerves under ultrasound guidance. Temporary pain relief for up to three months has been reported, and the procedure is considered well-tolerated.

Proprioception is defined as the sense of joint and limb position, mediated by receptors located in muscles, tendons, and joints. Assessment can be performed through simple methods, such as evaluating the ability to recognize specific joint angles or positions during passive or active movement. Proprioceptive deficits are frequently observed in osteoarthritis, and a better understanding of these changes is suggested to guide treatment strategies.

Enrollment: 44 estimated patients

Sex: All

Ages: 55 to 75 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Diagnosis of bilateral primary knee osteoarthritis according to ACR (American College of Rheumatology) criteria.
• Age between 55 and 75 years.
• Presence of knee osteoarthritis classified as Grade 2 or Grade 3 according to the Kellgren-Lawrence grading system on radiographs taken within the last year.
• Knee pain lasting longer than 6 months.
• Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score, total score 48-96

Exclusion criteria

• Severe knee trauma within the last 6 months.
• History of surgical operation on the knee region.
• Intra-articular steroid and/or hyaluronate injection into the knee joint within the last 6 months.
• Physical therapy targeting the knee within the last 6 months.
• Regular use of NSAIDs within the last 6 months.
• Presence of acute synovitis.
• Neurological deficits in the lower extremity.
• Presence of an inflammatory disease.
• Poor general health condition (e.g., heart failure, advanced asthma, history of malignancy).
• Any endocrine disorder that may cause polyneuropathy.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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44 participants in 2 patient groups

Genicular Nerve Block Group

Experimental group

Description:

A nerve block will be performed on 22 patients using lidocaine injection under ultrasound guidance. After obtaining informed consent, the procedure will be carried out following sterilization, with 2% lidocaine hydrochloride injected at a total volume of 6 mL, distributed as 2 mL for each of the superomedial, superolateral, and inferomedial branches of the genicular nerve. After the injection, bleeding control will be performed, and the procedure will be concluded. All ultrasound-guided injections will be performed by a single physician, and the examination, investigations, treatment, and clinical evaluations of the patients will be conducted by the physicians participating in the study.

Treatment:

Other: genicular nerve block

Other: Exercise

Exercise group

Active Comparator group

Description:

Exercise group: A home exercise program will be provided, including isometric strengthening exercises for the quadriceps muscles and stretching exercises for the hamstring muscles.

Treatment:

Other: Exercise