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. 2024 Jul 26;32(3):e277781.
doi: 10.1590/1413-785220243203e277781. eCollection 2024.

ULTRASOUND-GUIDED GENICULAR NERVE BLOCK FOR KNEE OSTEOARTHRITIS: A CASE SERIES

Ramon Chaves Ramalho  1 , Tifani Dawidowicz Fernandes  1 , Felipe de Freitas Peraro  1 , Gabriel Marques Pugliese  1 , Gustavo Gonçalves Arliani  1 , Gabriel Ferraz Ferreira  1
Affiliations

ULTRASOUND-GUIDED GENICULAR NERVE BLOCK FOR KNEE OSTEOARTHRITIS: A CASE SERIES

Ramon Chaves Ramalho et al. Acta Ortop Bras. .

Abstract
in English, Portuguese

Objective: Knee genicular nerve blocks have been a topic of discussion among various types of treatment for knee osteoarthritis. This study aims to evaluate the pain and function of patients diagnosed with knee osteoarthritis after undergoing ultrasound-guided genicular nerve blockade using pharmacological agents.

Methods: The study included 36 patients diagnosed with knee osteoarthritis, comprising 17 bilateral cases, totaling 53 knees undergoing UGNB using a mixture of triamcinolone, ropivacaine, and lidocaine under ultrasound guidance. Epidemiological data, pain outcomes measured by the Visual Analog Scale (VAS), and function assessed using the Western Ontario and McMaster Universities (WOMAC) score were evaluated before and after 12 weeks of the procedure.

Results: The mean age was 75.5 years (standard deviation of 9.4 years), with a predominance of females and right-sided involvement. There was a mean reduction of 3.0 points in VAS (p < 0.001) and 15.4 points in WOMAC (p < 0.001). Two cases reported only minor and transient complications related to the procedure (skin anesthesia and edema).

Conclusion: Ultrasound-guided genicular nerve blockade using pharmacological agents demonstrated pain reduction and improved function with a low complication rate after 12 weeks in patients with knee gonarthrosis. Level of Evidence IV, Case Series.

Objetivo: Os bloqueios geniculares do joelho têm sido tema de discussão entre os diversos tipos de tratamento da gonartrose. Este estudo tem por objetivo avaliar a dor e a função dos pacientes com diagnóstico de osteoartrose do joelho, após realização do procedimento de bloqueio farmacológico dos nervos geniculares (BFNG) guiado por ultrassom.

Métodos: O estudo incluiu 36 pacientes com diagnóstico de gonartrose, sendo 17 casos bilaterais, totalizando 53 joelhos submetidos ao BFNG, com a mistura de triancinolona, ropivacaína e lidocaína guiado por ultrassom. Avaliou-se dados epidemiológicos, desfechos de dor pela Escala Visual Analógica (EVA) e função com escore Western Ontario and Mcmaster Universities (WOMAC) antes e após 12 semanas do procedimento.

Resultados: A idade média encontrada foi de 75,5 anos (desvio padrão de 9,4 anos), com predominância do sexo feminino e do lado direito. Houve uma redução média na EVA de 3,0 pontos (p < 0,001) e no WOMAC de 15,4 (p < 0,001). Em dois casos, relataram apenas complicações menores e transitórias relacionadas ao procedimento (anestesia da pele e edema).

Conclusão: O bloqueio farmacológico dos nervos geniculares guiado por ultrassom demonstrou redução da dor e melhora na função, com baixa taxa de complicação após 12 semanas nos pacientes com gonartrose. Nível de evidência IV, Série de Casos.

Keywords: Anesthetics; Knee Osteoarthritis; Nerve Block; Pain; Ultrasonography.

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Conflict of interest statement

All authors declare no potential conflict of interest related to this article.

Figures

Figure 1.
Figure 1.. Comparison of VAS before and after intervention
Figure 2.
Figure 2.. Comparison of VAS before and after intervention considering the degree of Ahlbäck
See this image and copyright information in PMC

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