Ultrasound Guided Genicular Nerve Block for Knee Osteoarthritis – Comparing Methylprednisolone and Triamcinolone with Ropivacaine- Randomized Prospective Double Blinded Study

Abstract

Introduction: Chronic knee osteoarthritis (OA) commonly affects elderly population and is characterized by severe pain, joint stiffness and disability in using the joint. OA is a leading cause of disability worldwide. Genicular nerve block is effective procedure for chronic OA knee.
Aim: This study is to compare Triamcinolone and Methylprednisolone acetate with local anesthetic during ultrasound guided genicular nerve block (GNB) for knee OA.
Methodology: 50 patients were randomly divided into 2 groups. Group–A, 25 patients received 6ml of 0.5% Ropivacaine with 60mg Triamcinolone and Group–B, 25patient received 6ml of 0.5% Ropivacaine with 60mg Methylprednisolone acetate. VAS score and oxford knee score were assessed at baseline, 1, 2, 4 and 8 week intervals.
Results: The difference in VAS score between two groups were statistically insignificant (p value >0.05). Onset of drug in group A was 122.35±10.5 and group B was 117.9±15.4, which was statistically insignificant (p value >0.05). Oxford knee scoring in Group A was 30.1±1.4 and in Group B was 29.7±2.1, which was statistically insignificant (p value >0.05).
Conclusion: While considerable pain relief was achieved in all patients, the efficacy of both the drugs in chronic osteoarthritis is similar. Depending on patient factors either drug can be used in chronic osteoarthritis for pain relief.