Accepted Article
Title : Ultra-sound guided neurolysis of six genicular nerves of knee for intractable pain from knee osteoarthritis : A case series.
Running Head : Ultra-sound guided neurolysis of six genicular nerves.
Authors : 1. Dr Arif Ahmed, MD. 2. Dr Divesh Arora, MD.
Name of the institute where the study was conducted : Asian Institute of Medical Sciences, Badkal Flyover Road, Sector 21A, Faridabad, Haryana – 121001
Corresponding author : Dr Arif Ahmed Consultant , Department of Anaesthesiology and Pain Medicine Asian Institute of Medical Sciences, Badkal Flyover Road, Sector 21A, Faridabad, Haryana , India - 121001. Mobile Number - +919717378390 E-mail address :
[email protected] This article has been accepted for publication and undergone full peer review but has not been through the copyediting, typesetting, pagination and proofreading process, which may lead to differences between this version and the Version of Record. Please cite this article as doi: 10.1111/papr.12710 This article is protected by copyright. All rights reserved.
Accepted Article
The category for which the manuscript is being submitted : - Original article
Disclosure and Conflicts of Interest : None .
Level of evidence : IV
Source of Funding : None
What does this study add : The literature on neurolysis of genicular nerves of knee for osteoarthritis of knee is limited. There were on the three genicular nerve radiofrequency ablation and that too only for three branches of genicular nerves. This study will provide a level IV evidence that ultra-sound guided radiofrequency treatment of the genicular nerves is a safe and effective in treating knee pain from osteoarthritis of knee joint not responding to conservative modalities of treatment and who wants to avoid surgery.
Keywords : Knee pain, genicular nerve, ultra-sound guided, knee osteoarthritis, genicular nerve neurolysis.
Abstract : Introduction : Among the elderly populations, the chronic osteoarthritis of knee joint is one of the leading cause of disability and causes considerable pain, joint stiffness and functional limitations. Although knee replacement is a good option for the grade IV osteoarthritis, but many patients failed to undergo surgery due to co-morbidities or other reasons. Methods : Four patient with severe pain from grade III and IV osteoarthritis of knee joint had underwent ultrasound guided alcohol neurolysis of the six genicular nerves of knee joint after a positive genicular nerve block with local anesthetics. The demographics , pain intensity, Oxford knee score and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and quality of life was measured.
This article is protected by copyright. All rights reserved.
Results : There is significant improvement in pain intensity at rest, movement and on weight bearing from 8.75 ± 0.5, 9.0 ± 0.0 at baseline to 3.0 ± 0.81, 4.75 ± 0.95 and 4.5 ± 0.57, 4.50
Accepted Article
± 0.57 at 1 and 6 months after the procedure.
The oxford knee score and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score had improved from 7.75 ± 1.25 and 77.75 ± 4.34 at base line to at 20.75 ± 1.70 and 56.25 ± 3.09 at 1 month, and 18.25 ± 0.95 and 52.00 ± 2.16 respectively at 6 months respectively after the procedure(P value
