Effect of Genicular Nerve Block on Proprioception in Knee Osteoarthritis

April 8, 2026 updated by: Handan Elif Nur BAYRAKTAR, Ankara City Hospital Bilkent

Investigation of the Effect of Ultrasound-Guided Genicular Nerve Block on Knee Joint Proprioception in Patients With Chronic Knee Osteoarthritis

The study was conducted to investigate the effect of genicular nerve block on pain, quality of life, and proprioception, which are already diminished due to the impact of osteoarthritis in individuals with knee osteoarthritis.

Does genicular nerve block reduce pain and improve the quality of life in patients with knee osteoarthritis? Does genicular nerve block affect proprioception in patients with knee osteoarthritis?

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

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.

Study Type

Interventional

Enrollment (Actual)

40

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Turkey (Türkiye)
    • Çankaya
      • Ankara, Çankaya, Turkey (Türkiye), 06800
        • Ankara Bilkent City Hospital

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

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.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Genicular Nerve Block Group
A nerve block will be performed on 22 patients using lidocaine injection under ultrasound guidance. After obtaining informed consent, the procedure will be carried out following sterilization, with 2% lidocaine hydrochloride injected at a total volume of 6 mL, distributed as 2 mL for each of the superomedial, superolateral, and inferomedial branches of the genicular nerve. After the injection, bleeding control will be performed, and the procedure will be concluded. All ultrasound-guided injections will be performed by a single physician, and the examination, investigations, treatment, and clinical evaluations of the patients will be conducted by the physicians participating in the study.
Other: genicular nerve block
genicular nerve block
Other: Exercise
isometric exercise
Active Comparator: Exercise group

Exercise group:

A home exercise program will be provided, including isometric strengthening exercises for the quadriceps muscles and stretching exercises for the hamstring muscles.
Other: Exercise
isometric exercise

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Proprioception
Time Frame: Pre-treatment, 2 weeks, 1 month

Proprioception will be assessed using joint position sense. Joint position sense will be measured as the ability to actively replicate a joint position previously taught passively, referred to as Active Joint Position Sense (AJPS) (28). AJPS will be tested using a Continuous Passive Motion (CPM) device. The knee will be passively moved from 90° flexion toward extension at a slow pace. During this movement, the knee will be paused at 60°, 45°, and 30° flexion for 10 seconds each, and these angles will be taught to the participants. The knee will then be returned to 90° flexion, and the participants will be asked to actively replicate the taught angles.

Participants will actively move their knees from the starting position to the taught angles of 60°, 45°, and 30° flexion to identify these positions. The actual taught angles and the angles determined by the participants will be recorded, and the differences between them will be calculated. Each angle will be tested in three trials, and
Pre-treatment, 2 weeks, 1 month

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
The Nottingham Health Profile (NHP)
Time Frame: Pre-treatment, 2 weeks, 1 month
The Nottingham Health Profile (NHP) will be used to assess quality of life. The NHP is a general quality of life questionnaire that measures perceived health problems and their impact on normal daily activities. The questionnaire consists of 38 items and evaluates six dimensions of health status: energy (3 items), pain (8 items), emotional reactions (9 items), sleep (5 items), social isolation (5 items), and physical activity (8 items). Responses are given as "yes" or "no," and each section is scored on a scale from 0 to 100. A score of "0" indicates the best health status, while a score of "100" represents the worst health status.
Pre-treatment, 2 weeks, 1 month
Western Ontario and McMaster Universities Arthritis Index (WOMAC)
Time Frame: Pre-treatment, 2 weeks, 1 month

Pain, joint stiffness, and functional status will be assessed using the Western Ontario and McMaster Universities Arthritis Index (WOMAC). The WOMAC consists of 24 questions in total, divided into three subscales: pain (5 questions), joint stiffness (2 questions), and functional status (17 questions).

Each question is scored on a scale from 1 to 5, with higher scores indicating poorer health and lower scores indicating better health.
Pre-treatment, 2 weeks, 1 month
Visual Analog Scale (VAS)
Time Frame: Pre-treatment, 2 weeks, 1 month
Pain intensity will be assessed using the Visual Analog Scale (VAS) for evaluating current pain. Participants will be asked to rate their pain at rest, during movement, and at night. The scale ranges from 0 (no pain) to 10 (worst imaginable pain).
Pre-treatment, 2 weeks, 1 month

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Ankara City Hospital Bilkent

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

December 16, 2024

Primary Completion (Actual)

February 13, 2026

Study Completion (Actual)

April 8, 2026

Study Registration Dates

First Submitted

November 24, 2024

First Submitted That Met QC Criteria

December 16, 2024

First Posted (Actual)

December 20, 2024

Study Record Updates

Last Update Posted (Actual)

April 9, 2026

Last Update Submitted That Met QC Criteria

April 8, 2026

Last Verified

April 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • ANKARA-PMR-BEYZA-01

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

UNDECIDED

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

product manufactured in and exported from the U.S.

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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