Abstract

Knee osteoarthritis is one of the leading cause of disability worldwide. Most patients do not progress to TKA and of those that do, 15–40% continue to suffer from refractory knee pain. Genicular nerve neurolysis/Rhyzotomy and intra-articular steroid injection (IASI) are available treatment options for patients with knee osteoarthritis. Genicular nerve block (GNB) under fluoroscopy guidance is based on bony landmarks (area connecting the shaft to the epicondyle). This simple technique permitted successful blockade of three Genicular nerves and may be performed by local Anaesthetic drugs or Radiofrequency Ablation. In this study, I want to investigate the efficacy of IASI versus the combination of GNB and IASI in patients with knee osteoarthritis. Aims and Objectives: The primary objective of our study is to assess and compare the pain relief in patients after intra-articular injection of triamcinolone versus the combination of it with the Genicular nerve block. The secondary objective is to compare the functional capacity improvement as measured by WOMAC score. Methods: The prospective observational type of study was carried out on thirty patients with Kellgren–Lawrence grade 2–3 knee OA in the department of Anaesthesiology at Gandhi Medical College Bhopal after the approval of Institutional Ethics Committee of our hospital. The patients were assigned into 2 groups randomly as IASI (N=15) and GNB+IASI (N=15) group. Patients were assessed with a detailed history and thorough pre procedure examination. All the patients were evaluated with Visual analogue score (VAS) for pain intensity and Western Ontario and Mc Master Universities Osteoarthritis Index (WOMAC) for functional status of the patients. All assessments were measured and compared at baseline, 1 month, 3 month and 6th month after treatment. Results: All evaluation parameters were significantly improved in IASI and IASI+GNB groups. However, the WOMAC score of IASI+GNB group was significantly lower than WOMAC score of IASI group during all the intervals of time (p<0.001).

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