Comparing the effectiveness of ultrasound guided versus blind genicular nerve block on pain, muscle strength with isokinetic device, physical function and quality of life in chronic knee osteoarthritis: a prospective randomized controlled study
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Background: The genicular nerve block (GNB) is demonstrated from several reports to alleviate pain and improve knee functionality in patients with chronic knee osteoarthritis (OA). Ultrasound (US)-guided GNB has been the most used imaging method. This study aimed to compare the effectiveness of US-guided versus blind GNB in the treatment of knee OA. Methods: This prospective, randomized clinical trial included patients with knee OA based on American College of Rheumatology diagnostic criteria. The patients were evaluated for clinical and dynamometer parameters at the baseline, 4 weeks after treatment, and 12 weeks after treatment. The patients underwent blind injection or US-guided injection. Results: When compared with the baseline, both groups showed significant improvement in pain, physical function, and quality of life parameters. Significant differences were observed between the groups for clinical parameters (30-second chair stand test, 6-minute walk test) in favor of the US-guided group. On the other hand, blind injection was more significantly effective on some parameters of the Nottingham Health Profile. There wasn’t any significant improvement in isokinetic muscle strength for either group. Conclusions: This study demonstrated that both US-guided and blind GNB, in the treatment of knee OA, were effective in reducing symptoms and improving physical function. GNB wasn’t an effective treatment for isokinetic muscle function. USguided injections may yield more effective clinical results than blind injections.
Abstract
Background: The genicular nerve block (GNB) is demonstrated from several reports to alleviate pain and improve knee functionality in patients with chronic knee osteoarthritis (OA). Ultrasound (US)-guided GNB has been the most used imaging method. This study aimed to compare the effectiveness of US-guided versus blind GNB in the treatment of knee OA. Methods: This prospective, randomized clinical trial included patients with knee OA based on American College of Rheumatology diagnostic criteria. The patients were evaluated for clinical and dynamometer parameters at the baseline, 4 weeks after treatment, and 12 weeks after treatment. The patients underwent blind injection or US-guided injection. Results: When compared with the baseline, both groups showed significant improvement in pain, physical function, and quality of life parameters. Significant differences were observed between the groups for clinical parameters (30-second chair stand test, 6-minute walk test) in favor of the US-guided group. On the other hand, blind injection was more significantly effective on some parameters of the Nottingham Health Profile. There wasn’t any significant improvement in isokinetic muscle strength for either group. Conclusions: This study demonstrated that both US-guided and blind GNB, in the treatment of knee OA, were effective in reducing symptoms and improving physical function. GNB wasn’t an effective treatment for isokinetic muscle function. USguided injections may yield more effective clinical results than blind injections.
참고문헌 (24)
- Li CF, "Immediate responses of multi-focal low level laser therapy on quadriceps in knee osteoarthritis patients", Kaohsiung J Med Sci, 35, pp.702~707 (2019)
- Rushin Maria Dass, "Alcohol neurolysis of genicular nerve for chronic knee pain", The Korean Journal of Pain, 32(3), pp.223~227 (2019), 대한통증학회[DOI]
- Kim DH, "A prospective randomized comparison of the efficacy of ultrasound-vs fluoroscopy-guided genicular nerve block for chronic knee osteoarthritis", Pain Physician, 22, pp.139~146 (2019)
- Crawford DC, "Conservative management of symptomatic knee osteoarthritis: a flawed strategy?", Orthop Rev (Pavia), 5, pp.e2~ (2013)
- Santaguida PL, "Patient characteristics affecting the prognosis of total hip and knee joint arthroplasty : a systematic review", Can J Surg, 51, pp.428~436 (2008)
- Kesikburun S, "Ultrasound-guided genicular nerve pulsed radiofrequency treatment for painful knee osteoarthritis : a preliminary report", Pain Physician, 19, pp.E751~9 (2016)
- Choi WJ, "Radiofrequency treatment relieves chronic knee osteoarthritis pain : a double-blind randomized controlled trial", Pain, 152, pp.481~487 (2011)
- McCormick ZL, "Cooled radiofrequency ablation of the genicular nerves for chronic pain due to knee osteoarthritis : sixmonth outcomes", Pain Med, 18, pp.1631~1641 (2017)
- Protzman NM, "Examining the feasibility of radiofrequency treatment for chronic knee pain after total knee arthroplasty", PM R, 6, pp.373~376 (2014)
- Yasar E, "Accuracy of ultrasound-guided genicular nerve block : a cadaveric study", Pain Physician, 18, pp.E899~904 (2015)
- Sutaria RG, "Localization of the lateral retinacular nerve for diagnostic and therapeutic nerve block for lateral knee pain : a cadaveric study", PM R, 9, pp.149~153 (2017)
- Baert IAC, "Do psychosocial factors predict muscle strength, pain, or physical performance in patients with knee osteoarthritis?", J Clin Rheumatol, 23, pp.308~316 (2017)
- Altman R, "Development of criteria for the classification and reporting of osteoarthritis. Classification of osteoarthritis of the knee. Diagnostic and Therapeutic Criteria Committee of the American Rheumatism Association", Arthritis Rheum, 29, pp.1039~1049 (1986)
- Kellgren JH, "Radiological assessment of osteoarthrosis", Ann Rheum Dis, 16, pp.494~502 (1957)
- Yilmaz V, "The comparison of efficacy of single intraarticular steroid injection versus the combination of genicular nerve block and intraarticular steroid injection in patients with knee osteoarthritis : a randomised study", Musculoskelet Surg (2019)[DOI]
- Bellamy N, "Validation study of WOMAC : a health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee", J Rheumatol, 15, pp.1833~1840 (1988)
- Busija L, "Adult measures of general health and healthrelated quality of life: Medical Outcomes Study Short Form 36-Item (SF-36) and Short Form 12-Item (SF-12) Health Surveys, Nottingham Health Profile (NHP), Sickness Impact Profile (SIP), Medical Outcomes Study Short Form 6D (SF6D), Health Utilities Index Mark 3 (HUI3), Quality of WellBeing Scale (QWB), and Assessment of Quality of Life (AQoL)", Arthritis Care Res (Hoboken), 63(Suppl 11), pp.S383~412 (2011)
- Podsiadlo D, "The timed"Up & Go" : a test of basic functional mobility for frail elderly persons", J Am Geriatr Soc, 39, pp.142~148 (1991)
- Guyatt GH, "The 6-minute walk : a new measure of exercise capacity in patients with chronic heart failure", Can Med Assoc J, 132, pp.919~923 (1985)
- Jones CJ, "A 30-s chair-stand test as a measure of lower body strength in community-residing older adults", Res Q Exerc Sport, 70, pp.113~119 (1999)
- Norman GR, "Interpretation of changes in health-related quality of life : the remarkable universality of half a standard deviation", Med Care, 41, pp.582~592 (2003)
- Gkrilias P, "The relationship between isokinetic strength and functional performance tests in patients with knee osteoarthritis", J Phys Ther Sci, 30, pp.888~891 (2018)
- Kim DH, "Ultrasound-guided genicular nerve block for knee osteoarthritis: a double-blind, randomized controlled trial of local anesthetic alone or in combination with corticosteroid", Pain Physician, 21, pp.41~52 (2018)
- Maia PAV, "Viscosupplementation improves pain, function and muscle strength, but not proprioception, in patients with knee osteoarthritis: a prospective randomized trial", Clinics (Sao Paulo), 74, pp.e1207~ (2019)
