Adductor canal block versus intra-articular steroid and lidocaine injection for knee osteoarthritis: a randomized controlled study

Abstract

Background This study aimed to assess the efficacy of the adductor canal block (ACB) in comparison to intra-articular steroid-lidocaine injection (IASLI) to control chronic knee osteoarthritis (KOA) pain. Methods A randomized, single-blinded trial in an outpatient rehabilitation clinic recruiting chronic KOA with pain ≥ 6 months over one year. Following randomization, subjects received either a single ACB or IASLI under ultrasound guidance. Numerical rating scale (NRS) scores for pain, and Knee Injury and Osteoarthritis Outcome Scores (KOOS) were recorded at baseline, 1 hour, 1 month, and 3 months post-injection. Results Sixty-six knees were recruited; 2 were lost to follow-up. Age was normally distributed ( P = 0.463), with more female subjects in both arms ( P = 0.564). NRS scores improved significantly for both arms at 1 hour, with better pain scores for the IASLI arm ( P = 0.416) at 1st month and ACB arm at 3rd month ( P = 0.077) with larger effect size (Cohen’s d = 1.085). Lower limb function improved significantly in the IASLI arm at 1 month; the ACB subjects showed greater functional improvement at 3 months (Cohen’s d = 0.3, P = 0.346). Quality of life (QoL) improvement mirrored the functional scores whereby the IASLI group fared better at the 1st month ( P = 0.071) but at the 3rd month the ACB group scored better (Cohen’s d = 0.08, P = 0.710). Conclusions ACB provides longer lasting analgesia which improves function and QoL in chronic KOA patients up to 3 months without any significant side effects.

Predictive factors associated with successful response to utrasound guided genicular radiofrequency ablation

“…First and foremost, it prevents the exposure of healthcare workers and patients to radiation in long-term or repetitive procedures. The use of US is a dynamic examination and procedure; real-time visualization of the needle provides the recognition of neurovascular structures and musculotendinous elements and structural abnormalities [ 40 ]. Thus, complications such as hematoma and hemarthrosis can be prevented and the safety of the procedure can be increased.…”

The value of the peroneus brevis tendon cross-sectional area in early diagnosing of peroneus brevis tendinitis: The peroneus brevis tendon cross-sectional area

“…Especially, the diagnostic US images can provide useful information for diagnosing and directing treatment. [18][19][20][21][22][23][24][25][26][27][28][29] However, we focused only on how to measure the PBTCSA and PBTT on A-MRI. Second, there might be measurement errors associated with evaluating the PBTCSA and PBTT on A-MRI.…”

Ultrasound-guided PENG block versus intraarticular corticosteroid injection in hip osteoarthritis: a randomised controlled study

“…There is growing evidence in the literature that nerve blocks with local anesthetics (LAs) and corticosteroids are being offered for therapeutic purposes to patients with chronic pain. Ming et al [12] demonstrated that the adductor canal block provides pain relief which improves functionality and quality of life up to three months in knee OA. Another study demonstrated that ultrasoundguided genicular nerve blockage provided significant improvements in WOMAC, NRS, and Oxford Knee Score over 3 months [13].…”

“…With the increasing use of ultrasound technology, peripheral nerve blocks are used as an alternative treatment approach for OA [12][13][14]. The pericapsular nerve group (PENG) block is an interfascial plane block for the blockade of sensory nerve branches including the articular branches of the femoral (FN), obturator (ON), and accessory obturator (AON) nerves to the anterior hip capsule, with the limitation of quadriceps or adductor muscle weakness.…”