Effect of Genicular Nerve Block on Proprioception in Knee Osteoarthritis

Not Applicable

Recruiting

• Conditions: Osteoarthritis

• Registration Number: NCT06744842
• Lead Sponsor: Ankara City Hospital Bilkent

Brief Summary

The study was conducted to investigate the effect of genicular nerve block on pain, quality of life, and proprioception, which are already diminished due to the impact of osteoarthritis in individuals with knee osteoarthritis.

Does genicular nerve block reduce pain and improve the quality of life in patients with knee osteoarthritis? Does genicular nerve block affect proprioception in patients with knee osteoarthritis?

Detailed Description

Osteoarthritis (OA) is described as a degenerative joint disease characterized by cartilage erosion, osteophytes, subchondral sclerosis, and changes in the joint capsule, commonly observed in the elderly. Knee osteoarthritis is identified as the most prevalent form, with an increasing prevalence attributed to aging. It is recognized as a leading cause of disability, resulting in reduced quality of life and increased healthcare costs. Major risk factors include age, genetics, obesity, and muscle weakness. Current treatments focus on symptom management, with options including medication, physical therapy, and surgery.

Genicular nerve block is a minimally invasive procedure used to manage knee osteoarthritis pain by administering local anesthetics and corticosteroids near specific genicular nerves under ultrasound guidance. Temporary pain relief for up to three months has been reported, and the procedure is considered well-tolerated.

Proprioception is defined as the sense of joint and limb position, mediated by receptors located in muscles, tendons, and joints. Assessment can be performed through simple methods, such as evaluating the ability to recognize specific joint angles or positions during passive or active movement. Proprioceptive deficits are frequently observed in osteoarthritis, and a better understanding of these changes is suggested to guide treatment strategies.

Study Timeline

• Study First Submitted: 2024-11-24
• Status Verified: 2024-12
• Study Start: 2024-12-16
• Study First Submitted QC: 2024-12-16
• Last Update Submitted: 2024-12-16
• Study First Posted: 2024-12-20
• Last Update Posted: 2024-12-20
• Primary Completion: 2026-11-01
• Study Completion: 2026-12-15

Recruitment & Eligibility

• Status: RECRUITING
• Sex: All
• Target Recruitment: 44

Inclusion Criteria

• Diagnosis of bilateral primary knee osteoarthritis according to ACR (American College of Rheumatology) criteria.
• Age between 55 and 75 years.
• Presence of knee osteoarthritis classified as Grade 2 or Grade 3 according to the Kellgren-Lawrence grading system on radiographs taken within the last year.
• Knee pain lasting longer than 6 months.
• Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score, total score 48-96

Exclusion Criteria

• Severe knee trauma within the last 6 months.
• History of surgical operation on the knee region.
• Intra-articular steroid and/or hyaluronate injection into the knee joint within the last 6 months.
• Physical therapy targeting the knee within the last 6 months.
• Regular use of NSAIDs within the last 6 months.
• Presence of acute synovitis.
• Neurological deficits in the lower extremity.
• Presence of an inflammatory disease.
• Poor general health condition (e.g., heart failure, advanced asthma, history of malignancy).
• Any endocrine disorder that may cause polyneuropathy.

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Primary Outcome Measures

Name	Time	Method
Proprioception	Pre-treatment, 2 weeks, 1 month	Proprioception will be assessed using joint position sense. Joint position sense will be measured as the ability to actively replicate a joint position previously taught passively, referred to as Active Joint Position Sense (AJPS) (28). AJPS will be tested using a Continuous Passive Motion (CPM) device. The knee will be passively moved from 90° flexion toward extension at a slow pace. During this movement, the knee will be paused at 60°, 45°, and 30° flexion for 10 seconds each, and these angles will be taught to the participants. The knee will then be returned to 90° flexion, and the participants will be asked to actively replicate the taught angles.; Participants will actively move their knees from the starting position to the taught angles of 60°, 45°, and 30° flexion to identify these positions. The actual taught angles and the angles determined by the participants will be recorded, and the differences between them will be calculated. Each angle will be tested in three trials, and

Secondary Outcome Measures

Name	Time	Method
The Nottingham Health Profile (NHP)	Pre-treatment, 2 weeks, 1 month	The Nottingham Health Profile (NHP) will be used to assess quality of life. The NHP is a general quality of life questionnaire that measures perceived health problems and their impact on normal daily activities. The questionnaire consists of 38 items and evaluates six dimensions of health status: energy (3 items), pain (8 items), emotional reactions (9 items), sleep (5 items), social isolation (5 items), and physical activity (8 items). Responses are given as "yes" or "no," and each section is scored on a scale from 0 to 100. A score of "0" indicates the best health status, while a score of "100" represents the worst health status.
Western Ontario and McMaster Universities Arthritis Index (WOMAC)	Pre-treatment, 2 weeks, 1 month	Pain, joint stiffness, and functional status will be assessed using the Western Ontario and McMaster Universities Arthritis Index (WOMAC). The WOMAC consists of 24 questions in total, divided into three subscales: pain (5 questions), joint stiffness (2 questions), and functional status (17 questions).; Each question is scored on a scale from 1 to 5, with higher scores indicating poorer health and lower scores indicating better health.
Visual Analog Scale (VAS)	Pre-treatment, 2 weeks, 1 month	Pain intensity will be assessed using the Visual Analog Scale (VAS) for evaluating current pain. Participants will be asked to rate their pain at rest, during movement, and at night. The scale ranges from 0 (no pain) to 10 (worst imaginable pain).

Trial Locations

Locations (1)

Ankara Bilkent City Hospital; 🇹🇷 Ankara, Çankaya, Turkey