US Guided Genicular Nerve Block benefits in Osteoarthritis knee rehabilitation

The treatment of pain in Osteoarthritis (OA) knee is quite difficult. Intervention on the genicular nerves has recently been identified as a viable therapeutic option. Both transcutaneous electrical nerve stimulation (TENS) and Ultrasound guided genicular nerve block (GNB) are considered the standard of care.

In a recent trial Researchers from West Bengal have found out that genicular nerve block (GNB) is better than TENS with good clinical effects on knee OA and published the findings online in the Indian Journal of Physical Medicine and Rehabilitation on June 2021.

The study spanned over 18 months in the Department of Physical Medicine and Rehabilitation and a total of 64 patients (32 in each treatment group) were included. Group 1 received TENS for 3 weeks, while Group 2 received US-guided genicular nerve block (GNB).

The study primarily assessed Pain and knee function with visual acuity scale (VAS) and Western Ontario and McMaster (WOMAC) Universities index at baseline, 1, and 3 months.

Key findings of the study are:

• This study showed significant difference in knee pain, stiffness, and function after one month, with the GNB group outperforming the TENS group.

• In patients with primary OA knee, the overall outcome with both TENS and GNB was statistically beneficial, in reducing VAS for pain and WOMAC in the GNB group. Although, after 3 months, the VAS and WOMAC scores in both groups are equal.

• With all the benefits put together, GNB is a better alternative than TENS in the short term and similar in the long run, and both considerably contribute to the OA knee rehabilitation program.

"So, it can be concluded that GNB is a better choice than TENS in the short-term and comparable in the long-term and both add to the OA knee rehabilitation program significantly," said Dr. Ishita Dey.

Source

Dey I, Ghosal V, Konar A, et al. Comparison of the Therapeutic Efficacy of TENS vs Ultrasound-guided Genicular Nerve Block in Patients with Knee Osteoarthritis. Indian J Phys Med Rehab 2020;31(2):38–41.