Genicular Nerve Block in Juvenile Idiopathic Arthritis

Sohag University

Status and phase: Completed; Phase 4

Conditions: Persistent Knee Arthritis; no Intra-articular Injection in the Last 3 Months; no Other Cause for Chronic Kneearthritis; Juvenile Idiopathic Arthritis

Treatments: Drug: intra-articular steroid injection; Drug: genicular nerve block

Study type: Interventional

Funder types: Other

Identifiers

NCT04687930

8122020

Details and patient eligibility

About

N=104 juvenile idiopathic arthritis patients diagnosed after ILAR criteria with unilateral persistent knee arthritis. They will be randomly assigned into two groups; group 1 will receive genicular nerve block, group 2 intra-articular triamcinolone. Both groups will be examined by SOLAR ultrasound scoring system, Visual analogue scale and Lysholm score at 0, 2 and 12 weeks. A semi-quantitative score will be used to assess tenderness and swelling at the same intervals.

Enrollment: 104 patients

Sex: All

Ages: Under 16 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• juvenile idiopathic arthritis with persistent knee arthritis
• age below 16

Exclusion criteria

• severe knee osteoarthritis
• peripheral neuropathy,
• psoriatic arthritis,
• those under anticoagulant therapy, skin infection,
• prior knee injection in the last 3 months3
• those who have an allergy to Bupivacaine

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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104 participants in 2 patient groups

Active genicular nerve block group

Active Comparator group

Description:

group 1 will receive genicular nerve block. The injection and US examination will be done by two experienced sonographers. They were blinded to clinical data. Patients will also be blinded for the injected substance. Each point will be injected with 2 ml of Lidocaine hydrochloride 2 % (Xylocaine, Astrazeneca). The injection will be done using the 3 point technique (superior medial, superior lateral, and inferior medial genicular nerves).

Treatment:

Drug: genicular nerve block

intra-articular steroid injection group

Other group

Description:

while group 2 received intra-articular triamcinolone under ultrasound guidance and through injecting the supra-patellar bursa.

Treatment:

Drug: intra-articular steroid injection