Ultrasound-Guided Genicular Nerve Block for Knee Osteoarthritis: A Double-Blind, Randomized Controlled Trial of Corticosteroid v/s Phenol Neurolysis

This clinical study is a Double Blinded Randomized, active controlled, parallel group trial designed to evaluate and compare the efficacy of 6 percent phenol for ultrasound guided genicular nerves neurolysis v/s combination of local anesthetic with corticosteroid for treatment of patients with chronic knee pain due to osteoarthritis. This study will be conducted in department of Physical Medicine and Rehabilitation at AIIMS, New Delhi

A total of 30 participants having osteoarthritis knee with KL grade 3 or 4 radiographic changes and having Knee pain with NPRS  more than 5 during activities of daily living will be enrolled in the study and randomized equally into two groups.

The intervention group will receive 6 percent phenol and active control group will receive combination of local anesthetic and corticosteroid perineural around 3 genicular nerves namely superomedial, inferomedial and superolateral genicular nerves under ultrasound guidance. All patients will be given standard medical and rehabilitation program comprising of lifestyle modification, home based exercise protocol, knee orthosis as required. Patient  will be followed up at 2 weeks, 1 month, 2 months after injection.

Medical treatment will be continued to all patients in both groups for entire period of study. If patient in either group developed pain with NPRS more than 5 during study period, tablet paracetamol 500 mg PO SOS to maximum of 500 mg qid can be given as rescue medication.

Primary outcome of the study include pain in knee during activities of daily living using NPRS. Secondary outcomes include KOOS score, patient satisfaction score, amount of rescue medications taken