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The goal of this clinical trial is to evaluate whether genicular nerve block (GNB) is effective in reducing pain in patients with knee osteoarthritis. It will also assess the comparative efficacy of different injection protocols.
The main questions it aims to answer are:
Does genicular nerve block with corticosteroid and local anesthetic provide superior pain relief compared with local anesthetic alone or placebo?
Are there differences in clinical outcomes between the three treatment groups?
Researchers will compare three groups:
GNB with corticosteroid plus local anesthetic
GNB with local anesthetic alone
Sham procedure with saline (placebo control)
Participants will:
Receive the assigned injection protocol in accordance with their group
Be evaluated at baseline and scheduled follow-up visits for pain intensity and functional status
Report their pain scores and functional limitations using standardized assessment tools
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| genicular nerve block with local anesthetic | Active Comparator | Group 1 (GNB with local anesthetic only): Patients received a genicular nerve block (GNB) with 6 mL of 2% prilocaine and participated in a knee exercise program. |
|
| genicular nerve block with local anesthetic and corticosteroid | Active Comparator | Group 2 (GNB with local anesthetic and corticosteroid): Patients received GNB with 5 mL of 2% prilocaine in combination with 1 mL/40 mg of triamcinolone and followed the same exercise regimen. |
|
| sham injection with saline | Sham Comparator | Group 3 (Control group): Patients received a placebo injection (6 mL of 0.9% saline) with the knee exercise program. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Genicular nerve block with prilocaine | Drug | ultrasound guided genicular nerve block (GNB) injecting 6 mL of 2% prilocaine to the genicular nerves |
|
| Measure | Description | Time Frame |
|---|---|---|
| Pain intensity | Visual Analog Scale (VAS): The VAS assesses pain intensity on a 10-centimeter scale. Patients indicate their pain levels using two verbal descriptors at the end of each scale. | at baseline, 1 week, and 1 month after treatment |
| Measure | Description | Time Frame |
|---|---|---|
| Functional status using WOMAC | The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) questionnaire assessed pain and disability. | baseline, 1 week, and 1 month after treatment |
| Functional status using 40-Meter Fast Walking Test |
| Measure | Description | Time Frame |
|---|---|---|
| Ultrasound evaluation | Ultrasound measurements were taken to assess patellofemoral cartilage thickness and quadriceps muscle thickness | baseline |
Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Haydarpasa Numune Training and Research Hospital | Istanbul | Turkey (Türkiye) |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 39901967 | Background | Li W, Xu F, Chen F, Cao L, Bao X. Effect of Genicular Nerve Block (GNB) on Pain in Lesions of the Knee Joint: A Meta-Analysis of Randomized Controlled Trials. J Pain Res. 2025 Jan 30;18:511-522. doi: 10.2147/JPR.S503937. eCollection 2025. | |
| 30921977 | Background | Kim DH, Lee MS, Lee S, Yoon SH, Shin JW, Choi SS. A Prospective Randomized Comparison of the Efficacy of Ultrasound- vs Fluoroscopy-Guided Genicular Nerve Block for Chronic Knee Osteoarthritis. Pain Physician. 2019 Mar;22(2):139-146. |
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The study data are available with the researcher and can be provided to the relevant authorities if required.
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| ID | Term |
|---|---|
| D020370 | Osteoarthritis, Knee |
| D010146 | Pain |
| ID | Term |
|---|---|
| D010003 | Osteoarthritis |
| D001168 | Arthritis |
| D007592 | Joint Diseases |
| D009140 | Musculoskeletal Diseases |
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| ID | Term |
|---|---|
| D011318 | Prilocaine |
| D014221 | Triamcinolone |
| C005703 | salicylhydroxamic acid |
| ID | Term |
|---|---|
| D000813 | Anilides |
| D000577 | Amides |
| D009930 | Organic Chemicals |
| D000814 | Aniline Compounds |
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|
| genicular nerve block with prilocaine and triamcinolone | Drug | ultrasound guided genicular nerve block (GNB) injecting 5 mL of 2% prilocaine in combination with 1 mL/40 mg of triamcinolone to the genicular nerves |
|
|
| Sham injection | Drug | placebo injection using 6 mL of 0.9% saline to knee region other than genicular nerves |
|
|
40-Meter Fast Walking Test: This test involved a designated 10-meter walking track. Patients walked at their maximum pace for four laps. No warm-up was conducted, and the time spent turning at the lines was excluded from the calculation
| at baseline, 1 week, and 1 month after treatment |
| Pressure Pain Threshold (PPT) | Pressure Pain Threshold (PPT): The Commander Algometer (JTECH Medical, Utah, USA) was utilized to measure PPT at both the medial and lateral sides of the patella. The probe tip of the algometer was applied perpendicularly to the skin, and pressure was gradually increased. Patients indicated when they first experienced discomfort, at which point the measurement was recorded. This procedure was repeated three times, and the average value was noted. | baseline, 1 week, and 1 month after treatment |
| 29357330 | Background | Kim DH, Choi SS, Yoon SH, Lee SH, Seo DK, Lee IG, Choi WJ, Shin JW. Ultrasound-Guided Genicular Nerve Block for Knee Osteoarthritis: A Double-Blind, Randomized Controlled Trial of Local Anesthetic Alone or in Combination with Corticosteroid. Pain Physician. 2018 Jan;21(1):41-52. |
| 36369781 | 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. |
| D012216 |
| Rheumatic Diseases |
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D000588 |
| Amines |
| D011245 | Pregnadienes |
| D011278 | Pregnanes |
| D013256 | Steroids |
| D000072473 | Fused-Ring Compounds |
| D011083 | Polycyclic Compounds |
| D013259 | Steroids, Fluorinated |