만성 무릎 골관절염 환자의 영상 증폭 장치하 슬신경 차단과 초음파 유도하 슬신경 차단에 대한 효과 비교

Abstract

Background: Recently, genicular nerve block and radiofrequency ablation were introduced to alleviate knee pain in the patients with chronic knee osteoarthritis. There are two methods of genicular nerve block; ultrasound-guided versus fluoroscopy-guided. However, the superiority between them is unknown.

Methods: From July 2015 to September 2017, a randomized controlled study was performed to analyze the difference in the efficacy of genicular nerve block between ultrasound- and fluoroscopy-guidance. Numeric Rating Scale (NRS), Western Ontario and McMaster Universities Arthritis Index (WOMAC), Global Perceived Effect Scales (GPES) and complications were recorded at pre-procedure, 1 month, and 3 months after genicular nerve block.

Results: Total 80 patients were enrolled and randomized to the allocated group U (n=40) and the group F (n=40). We excluded patients who had no visit, follow-up loss, and other interventions, and finally analyzed 31 patients in the group U and 30 patients in the group F. There were no differences in NRS and WOMAC between the two groups at baselines and during follow-up period. GPES and complication rates were also similar among the two groups.

Conclusions: Pain relief, functional improvement, and safety were similar between ultrasound- and fluoroscopy-guided genicular nerve block. Therefore, either of two imaging devices can be selected to perform genicular nerve block for relieving chronic knee pain. However, considering radiation exposure, ultrasound might appear to be superior to guide genicular nerve block compared to fluoroscopy.