OUTCOME OF ULTRASOUND GUIDED VERSUS ANATOMICAL LANDMARK GUIDED MEDIAL GENICULAR NERVE BLOCK IN CHRONIC OSTEOARTHRITIS OF KNEE JOINT

Abstract

Objectives: Even-though various conservative treatments are available , numerous patients with chronic knee OA suffer from unbearable knee pain prior to total knee joint arthroplasty  .Medial genicular nerve block needs special attention because it is very effective technique in alleviating the knee pain in chronic OA   .Fewer studies have demonstrated the  effectiveness of different techniques used for administering Medial genicular nerve block (MGNB) for pain management of chronic knee osteoarthritis (OA) especially in Indian population. Hence in this  study we aim  to critically analyse and compare the  effectiveness of GNB administered using two pain management techniques—ultrasound-guided (USG) versus anatomical landmark-guided (ALG) —for chronic knee OA. Methods: This prospective cohort study included a total 79 patients with chronic knee OA who presented to our OPD during the study duration - April 2023 to February 2025. Among 79 patients, 29 of them were treated treatment with the USG guided technique and rest 50 with the anatomical landmark-guided technique. Pain assessment was done with VAS and functional outcome was assessed using the Western Ontario and McMaster Universities Osteoarthritis Index Questionnaire (WOMAC) and KSS at baseline and post-treatment one hour, 1 month, 3 month and 6 month. Results: Both USG & ALG groups reported a significant reduction in Pain and improved functional outcome (WOMAC and KSS) following MGNB. With respect to pain relief, Both methods achieve significant short-term relief within the first month, but their efficacy diminishes over 3–6 months. MGNB improves knee functionality (WOMAC scores and KSS), though these effects also decline by six months. Conclusions: MGNB administration using USG and ALG techniques are both effective in significantly reducing pain and improving functional outcomes in patients suffering from chronic knee OA. Statistical comparisons consistently indicate no significant difference in outcomes between ALG and USG approaches, supporting the conclusion that both methods are equally effective for pain management and functional improvement .The treatment is safe, and both methods are similarly effective, offering flexible choices for clinical application.