A randomized open label comparative study on efficacy of ultrasonography guided vis a vis anatomical landmark guided genicular nerve block in knee osteoarthritis in a tertiary care hospital in Eastern India

Abstract

Introduction: Osteoarthritis is a widespread health problem throughout the world, with 20%-30% of patients aged over 65 years reported as symptomatic. This painful condition often unmanageable with conservative management.

Objective: To compare the efficacy and safety of USG guided genicular nerve block and by anatomical landmark guided blind procedure in patients with OA knee.Materials & Methods: A parallel group open level randomized prospective study was conducted on patients suffering osteoarthritis of knee divided into ultrasound guided genicular nerve block (n=44) and anatomical landmark guided blind method (n=45) at a tertiary care hospital and followed up over a period of 12 weeks with assessment of pain, stiffness and function measured by visual analogue scale (VAS) and Western Ontorio and McMaster Universities Osteoarthritis (WOMAC) at regular interval.Results: A significant improvement in pain, stiffness and function (p<0.001) observed at 4and 12 weeks of interval in both the study group. Ultra sound guided group showed a better result (p<0.05) when compared to anatomical landmark guided blind group at 4th and 12th weeks interval with lesser complication like bleeding.Conclusion: Genicular nerve block (both Ultrasound guided and anatomical landmark guided blind) are both effective method for pain and stiffness reduction in osteoarthritis of knee with less adverse effects. Long term pain control was significantly greater in ultrasound aided block nerve.