Effect of Genicular Nerve Block on Proprioception in Knee Osteoarthritis

Osteoarthritis (OA) is described as a degenerative joint disease characterized by cartilage erosion, osteophytes, subchondral sclerosis, and changes in the joint capsule, commonly observed in the elderly. Knee osteoarthritis is identified as the most prevalent form, with an increasing prevalence attributed to aging. It is recognized as a leading cause of disability, resulting in reduced quality of life and increased healthcare costs. Major risk factors include age, genetics, obesity, and muscle weakness. Current treatments focus on symptom management, with options including medication, physical therapy, and surgery.

Genicular nerve block is a minimally invasive procedure used to manage knee osteoarthritis pain by administering local anesthetics and corticosteroids near specific genicular nerves under ultrasound guidance. Temporary pain relief for up to three months has been reported, and the procedure is considered well-tolerated.

Proprioception is defined as the sense of joint and limb position, mediated by receptors located in muscles, tendons, and joints. Assessment can be performed through simple methods, such as evaluating the ability to recognize specific joint angles or positions during passive or active movement. Proprioceptive deficits are frequently observed in osteoarthritis, and a better understanding of these changes is suggested to guide treatment strategies.

Inclusion criteria

• Diagnosis of bilateral primary knee osteoarthritis according to ACR (American College of Rheumatology) criteria.
• Age between 55 and 75 years.
• Presence of knee osteoarthritis classified as Grade 2 or Grade 3 according to the Kellgren-Lawrence grading system on radiographs taken within the last year.
• Knee pain lasting longer than 6 months.
• Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score, total score 48-96

Exclusion criteria

• Severe knee trauma within the last 6 months.
• History of surgical operation on the knee region.
• Intra-articular steroid and/or hyaluronate injection into the knee joint within the last 6 months.
• Physical therapy targeting the knee within the last 6 months.
• Regular use of NSAIDs within the last 6 months.
• Presence of acute synovitis.
• Neurological deficits in the lower extremity.
• Presence of an inflammatory disease.
• Poor general health condition (e.g., heart failure, advanced asthma, history of malignancy).
• Any endocrine disorder that may cause polyneuropathy.