Short- and mid-term clinical results of ultrasound-guided genicular nerve block in arthroplasty-related chronic postsurgical pain

Abstract

One-third of patients experience knee arthroplasty-related chronic postsurgical pain (CPSP), and CPSP negatively affects all dimensions of quality of life. We aimed to evaluate the short- and mid-term clinical results and success of ultrasound-guided genicular nerve block in patients with knee arthroplasty-related CPSP. The secondary outcome aimed to evaluate the relationship between clinical success and the presence of neuropathic pain. This study is a retrospective chart review of patients with knee arthroplasty-related CPSP who were referred to a pain clinic and were unresponsive to conservative treatments. Clinical evaluations of the patients at one, three, and six months before and after the procedure were obtained from patient records. Pain intensity was evaluated with a 10-point numerical rating scale (NRS), the effects of knee pain on function were evaluated with the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scoring system, and the presence of neuropathic pain was evaluated with the Douleur Neuropathic Pain 4 Questions. The clinical success of the procedure was accepted as a 50% or more reduction in pain intensity. A total of 21 patients were evaluated. The therapy was successful in 13 (61.9%), 12 (57.1%), and 7 (33.3%) patients at the first-, third-, and sixth-month visits, respectively. A statistically significant difference was found between the NRS and WOMAC scores. At baseline neuropathic pain was present in 61.9% (n = 13) of the patients, and the presence of neuropathic pain was not related to clinical success at the first-, third-, and sixth-month visits. Ultrasound-guided genicular nerve block relieves pain and improves functionality in the short- and mid-term for patients with knee arthroplasty-related CPSP. Clinical success was detected in two-thirds of the patients in the early period and in one-third of the patients at the sixth month.

Keywords

• knee arthroplasty
• chronic postsurgical pain
• genicular nerve block
• neuropathic pain

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