Genicular Nerve Block, Gonarthritis, Gonarthrosis; Primary
Conditions
Keywords
genicular nerve block, knee osteoarthritis, pain, disability, gonarthrosis
Brief summary
The goal of this clinical trial is to evaluate whether genicular nerve block (GNB) is effective in reducing pain in patients with knee osteoarthritis. It will also assess the comparative efficacy of different injection protocols. The main questions it aims to answer are: Does genicular nerve block with corticosteroid and local anesthetic provide superior pain relief compared with local anesthetic alone or placebo? Are there differences in clinical outcomes between the three treatment groups? Researchers will compare three groups: GNB with corticosteroid plus local anesthetic GNB with local anesthetic alone Sham procedure with saline (placebo control) Participants will: Receive the assigned injection protocol in accordance with their group Be evaluated at baseline and scheduled follow-up visits for pain intensity and functional status Report their pain scores and functional limitations using standardized assessment tools
Interventions
DRUGGenicular nerve block with prilocaine
ultrasound guided genicular nerve block (GNB) injecting 6 mL of 2% prilocaine to the genicular nerves
DRUGgenicular nerve block with prilocaine and triamcinolone
ultrasound guided genicular nerve block (GNB) injecting 5 mL of 2% prilocaine in combination with 1 mL/40 mg of triamcinolone to the genicular nerves
DRUGSham injection
placebo injection using 6 mL of 0.9% saline to knee region other than genicular nerves
Sponsors
Haydarpasa Numune Training and Research Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Investigator)
Eligibility
Sex/Gender
ALL
Age
45 Years to 75 Years
Healthy volunteers
No
Inclusion criteria
* age between 45 and 75 * diagnosed with knee osteoarthritis (OA) according to the American College of Rheumatology (ACR) criteria * possessing a Kellgren-Lawrence radiological grade of 2-3
Exclusion criteria
* any joint injection to the target knee in the past 3 months * physical therapy for the target knee within the last 3 months * previous knee surgery * inflammatory rheumatic diseases * active lumbar radiculopathy on the same side * neurological disorders (e.g., Alzheimer's or dementia) * uncontrolled cardiopulmonary diseases * pregnancy or lactation * obesity (body mass index \[BMI\] \>35) * presence of a pacemaker * active malignancy
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Pain intensity | at baseline, 1 week, and 1 month after treatment | Visual Analog Scale (VAS): The VAS assesses pain intensity on a 10-centimeter scale. Patients indicate their pain levels using two verbal descriptors at the end of each scale. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Functional status using WOMAC | baseline, 1 week, and 1 month after treatment | The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) questionnaire assessed pain and disability. |
| Functional status using 40-Meter Fast Walking Test | at baseline, 1 week, and 1 month after treatment | 40-Meter Fast Walking Test: This test involved a designated 10-meter walking track. Patients walked at their maximum pace for four laps. No warm-up was conducted, and the time spent turning at the lines was excluded from the calculation |
| Pressure Pain Threshold (PPT) | baseline, 1 week, and 1 month after treatment | Pressure Pain Threshold (PPT): The Commander Algometer (JTECH Medical, Utah, USA) was utilized to measure PPT at both the medial and lateral sides of the patella. The probe tip of the algometer was applied perpendicularly to the skin, and pressure was gradually increased. Patients indicated when they first experienced discomfort, at which point the measurement was recorded. This procedure was repeated three times, and the average value was noted. |
Other
| Measure | Time frame | Description |
|---|---|---|
| Ultrasound evaluation | baseline | Ultrasound measurements were taken to assess patellofemoral cartilage thickness and quadriceps muscle thickness |
Countries
Turkey (Türkiye)
Outcome results
None listed