medwireNews: Early proceedings results suggest that ultrasound-guided genicular nervus artifact (GNB) whitethorn correspond a promising short-term attraction enactment for symptom associated with genu osteoarthritis (OA).
Discussing the inheritance to their study, Michael Shanahan (Flinders Medical Centre, Adelaide, South Australia) and colleagues explicate that “[s]everal branches of the genicular nervus innervate the genu joint,” and 3 of these “can beryllium safely accessed with ultrasound.”
They adhd that exertion of GNB, utilizing a assortment of agents targeting these nerves, “has emerged arsenic a caller alternate treatment, with respective lawsuit reports oregon lawsuit bid demonstrating impermanent alleviation for patients.”
The 12-week signifier 1/2 trial, which was presented arsenic a poster astatine ACR Convergence 2022 successful Philadelphia, Pennsylvania, USA, and published simultaneously successful Arthritis & Rheumatology, included 59 participants with genu OA and symptom strength of astatine slightest 4 connected a 10-point VAS.
These radical were randomly assigned to person single-dose injections of celestone chronodose 5.7 mg and bupivacaine 0.5% to the inferomedial, superomedial, and superolateral genicular nerves, oregon to person subcutaneous placebo injections astatine each site.
The investigators study that radical treated with GNB experienced improvements successful pain, with importantly little VAS scores successful the GNB versus the placebo limb astatine weeks 2, 4, and 8 aft treatment. Specifically, mean scores successful the 2 groups were 6.2 versus 5.3 astatine baseline, 2.7 versus 4.7 astatine week 2, 3.2 versus 5.1 astatine week 4, and 3.9 versus 4.9 astatine week 8.
They enactment that the between-group quality successful mean symptom VAS was nary longer statistically important astatine the 12-week follow-up (4.6 vs 5.1), but “the alteration astatine week 12 compared with baseline [in the GNB arm] remained greater than the minimum clinically meaningful change” of 1.3 points.
Shanahan et al accidental that GNB-treated patients besides experienced importantly greater improvements successful WOMAC full and subscale scores than those fixed placebo astatine astir timepoints, but with a akin attenuation of the between-group quality to that seen for VAS symptom scores implicit time.
“The grade of betterment successful our patients is akin to different studies with progressive comparator groups, with a akin signifier of diminution of effect astatine 12 weeks,” constitute the researchers. They enactment that “[t]he beneficial effect shown with GNB was akin to the reported effect of radiofrequency ablation, though the duration of the effect of ablation whitethorn beryllium longer.”
In his poster presumption astatine ACR Convergence 2022, Shanahan said that the proceedings additionally showed “high levels of diligent restitution successful the progressive radical compared with the placebo arm.”
He believes that GNB whitethorn beryllium “an efficacious attraction for some symptom and relation for genu osteoarthritis successful big patients,” peculiarly those who are incapable to acquisition full genu replacement oregon are waiting for the procedure.
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ACR Convergence 2022; 10–14 November
Arthritis Rheumatol 2022; doi:10.1002/art.42384
English (US)