Comparative Evaluation of the Effectiveness of Adductor Canal Block versus Conservative Treatment for the Management of Anteromedial Knee Pain in Knee Osteoarthritis: A Prospective Study

Context: Knee osteoarthritis (KOA) is the most common type of lower extremity osteoarthritis (OA), with pain being the predominant symptom, leading to significant morbidity and impaired quality of life. Objectives: This study was designed to ascertain the effectiveness of ultrasound-guided adductor...

Full description

Saved in:
Bibliographic Details
Main Authors: Anil Sharma, Nidhi Negi, Mrinal Joshi
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2024-05-01
Series:Indian Journal of Physical Medicine & Rehabilitation
Subjects:
Online Access:https://journals.lww.com/10.4103/ijpmr.ijpmr_28_24
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1846119234984214528
author Anil Sharma
Nidhi Negi
Mrinal Joshi
author_facet Anil Sharma
Nidhi Negi
Mrinal Joshi
author_sort Anil Sharma
collection DOAJ
description Context: Knee osteoarthritis (KOA) is the most common type of lower extremity osteoarthritis (OA), with pain being the predominant symptom, leading to significant morbidity and impaired quality of life. Objectives: This study was designed to ascertain the effectiveness of ultrasound-guided adductor canal block (ACB), ensuing functional improvement and change in the quality of life in KOA patients with anteromedial knee pain and compare it with conservative treatment. Materials and Methods: A total of 196 patients were recruited for this trial and initially treated conservatively with oral analgesics and exercise. At the end of 2 and 4 weeks from the inclusion date, they were offered a crossover to the intervention with ACB for the saphenous nerve. The outcome measures, such as Visual Analogue Scale (VAS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score, Timed Up and Go test, number of analgesics ingested per day and World Health Organization Quality of Life-BREF (WHOQoL-BREF) scores, were recorded at pre-decided time points. Results: After multiple structured follow-ups, 76 and 86 patients were analysed in the intervention and conservative groups, respectively. The two groups had no significant differences in the demographic and clinical patterns. The intervention group showed improvements in VAS (at week 2) (P < 0.05), WOMAC and the number of analgesics ingested per day (weeks 2 and 4) (P < 0.05). At ‘week 8’ follow-up, most patient outcomes including physical health and psychological domains of WHOQoL-BREF scores were better for conservative group (P < 0.05). The rest of the outcome measures were comparable for both groups at all time points. No adverse events were reported. Conclusion: This study suggests that ACB is effective only for a short duration and does not offer any significant advantage over conservative management in the long run.
format Article
id doaj-art-6a2dc65f975d4f7fa8be93c823ab30c5
institution Kabale University
issn 0973-2209
2949-8058
language English
publishDate 2024-05-01
publisher Wolters Kluwer Medknow Publications
record_format Article
series Indian Journal of Physical Medicine & Rehabilitation
spelling doaj-art-6a2dc65f975d4f7fa8be93c823ab30c52024-12-17T06:36:42ZengWolters Kluwer Medknow PublicationsIndian Journal of Physical Medicine & Rehabilitation0973-22092949-80582024-05-0134213214310.4103/ijpmr.ijpmr_28_24Comparative Evaluation of the Effectiveness of Adductor Canal Block versus Conservative Treatment for the Management of Anteromedial Knee Pain in Knee Osteoarthritis: A Prospective StudyAnil SharmaNidhi NegiMrinal JoshiContext: Knee osteoarthritis (KOA) is the most common type of lower extremity osteoarthritis (OA), with pain being the predominant symptom, leading to significant morbidity and impaired quality of life. Objectives: This study was designed to ascertain the effectiveness of ultrasound-guided adductor canal block (ACB), ensuing functional improvement and change in the quality of life in KOA patients with anteromedial knee pain and compare it with conservative treatment. Materials and Methods: A total of 196 patients were recruited for this trial and initially treated conservatively with oral analgesics and exercise. At the end of 2 and 4 weeks from the inclusion date, they were offered a crossover to the intervention with ACB for the saphenous nerve. The outcome measures, such as Visual Analogue Scale (VAS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score, Timed Up and Go test, number of analgesics ingested per day and World Health Organization Quality of Life-BREF (WHOQoL-BREF) scores, were recorded at pre-decided time points. Results: After multiple structured follow-ups, 76 and 86 patients were analysed in the intervention and conservative groups, respectively. The two groups had no significant differences in the demographic and clinical patterns. The intervention group showed improvements in VAS (at week 2) (P < 0.05), WOMAC and the number of analgesics ingested per day (weeks 2 and 4) (P < 0.05). At ‘week 8’ follow-up, most patient outcomes including physical health and psychological domains of WHOQoL-BREF scores were better for conservative group (P < 0.05). The rest of the outcome measures were comparable for both groups at all time points. No adverse events were reported. Conclusion: This study suggests that ACB is effective only for a short duration and does not offer any significant advantage over conservative management in the long run.https://journals.lww.com/10.4103/ijpmr.ijpmr_28_24adductor canal blockknee painosteoarthritis kneesaphenous nerveultrasound-guided
spellingShingle Anil Sharma
Nidhi Negi
Mrinal Joshi
Comparative Evaluation of the Effectiveness of Adductor Canal Block versus Conservative Treatment for the Management of Anteromedial Knee Pain in Knee Osteoarthritis: A Prospective Study
Indian Journal of Physical Medicine & Rehabilitation
adductor canal block
knee pain
osteoarthritis knee
saphenous nerve
ultrasound-guided
title Comparative Evaluation of the Effectiveness of Adductor Canal Block versus Conservative Treatment for the Management of Anteromedial Knee Pain in Knee Osteoarthritis: A Prospective Study
title_full Comparative Evaluation of the Effectiveness of Adductor Canal Block versus Conservative Treatment for the Management of Anteromedial Knee Pain in Knee Osteoarthritis: A Prospective Study
title_fullStr Comparative Evaluation of the Effectiveness of Adductor Canal Block versus Conservative Treatment for the Management of Anteromedial Knee Pain in Knee Osteoarthritis: A Prospective Study
title_full_unstemmed Comparative Evaluation of the Effectiveness of Adductor Canal Block versus Conservative Treatment for the Management of Anteromedial Knee Pain in Knee Osteoarthritis: A Prospective Study
title_short Comparative Evaluation of the Effectiveness of Adductor Canal Block versus Conservative Treatment for the Management of Anteromedial Knee Pain in Knee Osteoarthritis: A Prospective Study
title_sort comparative evaluation of the effectiveness of adductor canal block versus conservative treatment for the management of anteromedial knee pain in knee osteoarthritis a prospective study
topic adductor canal block
knee pain
osteoarthritis knee
saphenous nerve
ultrasound-guided
url https://journals.lww.com/10.4103/ijpmr.ijpmr_28_24
work_keys_str_mv AT anilsharma comparativeevaluationoftheeffectivenessofadductorcanalblockversusconservativetreatmentforthemanagementofanteromedialkneepaininkneeosteoarthritisaprospectivestudy
AT nidhinegi comparativeevaluationoftheeffectivenessofadductorcanalblockversusconservativetreatmentforthemanagementofanteromedialkneepaininkneeosteoarthritisaprospectivestudy
AT mrinaljoshi comparativeevaluationoftheeffectivenessofadductorcanalblockversusconservativetreatmentforthemanagementofanteromedialkneepaininkneeosteoarthritisaprospectivestudy