Effect of Genicular Nerve Block on Proprioception in Knee Osteoarthritis

NCT06744842 | Completed

• 1 other identifier: ANKARA-PMR-BEYZA-01
• Study Type: interventional
• Target: 40
• Locations: 1 country
• Sites: 1

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?

Conditions

Osteoarthritis

Keywords

Genicular nerve block; Proprioception; Osteoarthritis

Outcome Measures

Primary Outcomes (1)

• Proprioception

  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

  Pre-treatment, 2 weeks, 1 month

Secondary Outcomes (3)

• The Nottingham Health Profile (NHP)

  Pre-treatment, 2 weeks, 1 month

• Western Ontario and McMaster Universities Arthritis Index (WOMAC)

  Pre-treatment, 2 weeks, 1 month

• Visual Analog Scale (VAS)

  Pre-treatment, 2 weeks, 1 month

Study Arms (2)

Genicular Nerve Block Group

EXPERIMENTAL

A nerve block will be performed on 22 patients using lidocaine injection under ultrasound guidance. After obtaining informed consent, the procedure will be carried out following sterilization, with 2% lidocaine hydrochloride injected at a total volume of 6 mL, distributed as 2 mL for each of the superomedial, superolateral, and inferomedial branches of the genicular nerve. After the injection, bleeding control will be performed, and the procedure will be concluded. All ultrasound-guided injections will be performed by a single physician, and the examination, investigations, treatment, and clinical evaluations of the patients will be conducted by the physicians participating in the study.

Other: genicular nerve block; Other: Exercise

Exercise group

ACTIVE COMPARATOR

Exercise group: A home exercise program will be provided, including isometric strengthening exercises for the quadriceps muscles and stretching exercises for the hamstring muscles.

Other: Exercise

Interventions

genicular nerve block OTHER

genicular nerve block

Genicular Nerve Block Group

Exercise OTHER

isometric exercise

Exercise group; Genicular Nerve Block Group

Eligibility Criteria

• Age: 55 Years - 75 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• 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

You may not qualify if:

• 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.

Sponsors & Collaborators

• Ankara City Hospital Bilkent: lead

Study Sites (1)

Ankara Bilkent City Hospital

Ankara, Çankaya, 06800, Turkey (Türkiye)

Location

Related Publications (13)

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  PMID: 35594623 BACKGROUND

• Shanahan EM, Robinson L, Lyne S, Woodman R, Cai F, Dissanayake K, Paddick K, Cheung G, Voyvodic F. Genicular Nerve Block for Pain Management in Patients With Knee Osteoarthritis: A Randomized Placebo-Controlled Trial. Arthritis Rheumatol. 2023 Feb;75(2):201-209. doi: 10.1002/art.42384. Epub 2022 Nov 11.

  PMID: 36369781 BACKGROUND

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  PMID: 6119626 BACKGROUND

• Liu SH, Dube CE, Eaton CB, Driban JB, McAlindon TE, Lapane KL. Longterm Effectiveness of Intraarticular Injections on Patient-reported Symptoms in Knee Osteoarthritis. J Rheumatol. 2018 Aug;45(9):1316-1324. doi: 10.3899/jrheum.171385. Epub 2018 Jun 15.

  PMID: 29907665 BACKGROUND

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  PMID: 30782000 BACKGROUND

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  PMID: 11239308 BACKGROUND

• Brandt KD, Heilman DK, Slemenda C, Katz BP, Mazzuca S, Braunstein EM, Byrd D. A comparison of lower extremity muscle strength, obesity, and depression scores in elderly subjects with knee pain with and without radiographic evidence of knee osteoarthritis. J Rheumatol. 2000 Aug;27(8):1937-46.

  PMID: 10955336 BACKGROUND

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  PMID: 11074906 BACKGROUND

MeSH Terms

Conditions

Osteoarthritis

Interventions

Exercise

Condition Hierarchy (Ancestors)

Arthritis; Joint Diseases; Musculoskeletal Diseases; Rheumatic Diseases

Intervention Hierarchy (Ancestors)

Motor Activity; Movement; Musculoskeletal Physiological Phenomena; Musculoskeletal and Neural Physiological Phenomena

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: PARTICIPANT
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: specialist

Study Record Dates

• First Submitted: November 24, 2024
• First Posted: December 20, 2024
• Study Start: December 16, 2024
• Primary Completion: February 13, 2026
• Study Completion: April 8, 2026
• Last Updated: April 9, 2026

Record last verified: 2026-04

Locations

TU (1)