Effects of Ultrasound-guided Genicular Nerve Block in Knee Osteoarthritis Patients on Proprioception and Static Balance

Ankara City Hospital

Status: Completed

Conditions: Proprioceptive Disorders; Balance; Distorted; Osteoarthritis; Osteoarthritis, Knee

Treatments: Drug: Genicular blocks (dexamethazone and lidocaine)

Study type: Interventional

Funder types: Other

Identifiers

NCT06527651

2

Details and patient eligibility

About

Genicular nerve block (GNB) is a novel and promising interventional method for pain in knee osteoarthritis (KOA). However ,it contains afferent fibers that receive impulses from proprioceptive and deep sensory receptors located in the joint capsule, ligaments, muscles, tendons and periosteum. These proprioceptive stimuli are effective on joint position and biomechanics, protect the joint from injuries and help maintain balance. This study aims to evaluate Pproprioception and static balance after ultrasound-guided GNB in patients with knee osteoarthritis.

Full description

Genicular nerve block (GNB) is a novel and promising interventional method for pain in knee osteoarthritis (KOA). However ,it contains afferent fibers that receive impulses from proprioceptive and deep sensory receptors located in the joint capsule, ligaments, muscles, tendons and periosteum. These proprioceptive stimuli are effective on joint position and biomechanics, protect the joint from injuries and help maintain balance. This study aims to evaluate Pproprioception and static balance after ultrasound-guided GNB in patients with knee osteoarthritis.

Enrollment: 22 patients

Sex: All

Ages: 50 to 70 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Chronic knee pain more than >3 according to visual analog scale (VAS) and difficulty in function more than 3 months
• Grade 2-3 KOA according to the Kellgren -Lawrence radiological grading system
• No significant improvement in response to conservative treatments such as analgesics and physiotherapy.

Exclusion criteria

• History of trauma, fractures, malignencies, surgery and inflammatory diseases of knee
• Limitation of range of motion in unilaterally and/or bilaterally in knee joint
• Allergies of pharmacological agents using during procedure (lidocaine)
• Presence of intra-articular or peri-articular injection such as hyaluronic acids, corticosteroids or collagen supplements at last 6 months
• Other neurologic or rheumatological conditions that may lead vertigo or vestibular disfunction or presence of impairment in proprioception such as polineuropathy
• Presence of diabetes mellitus due to risk of small fiber neuropathy
• Cognitive impairment and uncontrolled systemic conditions.

Trial design

Primary purpose: Treatment

Allocation: N/A

Interventional model: Single Group Assignment

Masking: None (Open label)

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22 participants in 1 patient group

Genicular blocks

Other group

Description:

Genicular blocks were applied bilaterally by another physiatrist who was experienced in ultrasonographic (US) interventional procedures more than 5 years. Total of 6mL solution consisting of 0.5 mg/2mL dexamethazone and 4mL %1 lidocaine for three branches of genicular nerves (superomedial, superolateral and inferomedial branches) was divided into three branches for each knee. Total of 12 mL solution was applied for each patient. Antiseptic precautions were taken, sterile environment was prepared. A 5-12 MHz linear probe (Loqiq P5, GE Medical systems) was used for all US evaluations. The probe was positioned in line with the femur shaft. Firstly to find the superomedial genicular nerve, probe was moved to the junction of femur shaft and medial femoral condyle. Color doppler was used to clarify superomedial genicular artery and 2mL injection solution was applied around the pulsatile artery region.

Treatment:

Drug: Genicular blocks (dexamethazone and lidocaine)