Conclusion
The ultrasound-guided genicular nerve block is a safe, simple technique for treating acute on chronic knee pain. The block provides both the immediate relief that the patient desires and sustained functional improvement that will help prevent bouncebacks, while avoiding the risks associated with opioid prescriptions or injections that violate the joint space. This block is commonly offered in outpatient pain clinics but can be easily adapted to the ED setting.5,6
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ACEP Now: Vol 43 – No 05 – May 2024Dr. Stegeman is an Ultrasound Fellow at Alameda Health System / Highland Hospital.
Dr. Mikell is an Ultrasound Fellow at Alameda Health System / Highland Hospital.
Dr. Martin is the Ultrasound Fellowship Director at Alameda Health System / Highland Hospital.
Dr. Nagdev is the Ultrasound Division Director, Alameda Health System / Highland Hospital.
References
- Gwam CU, Etcheson JI, George NE, Mistry JB, Mohamed N, Patel A, Gwam PN, Piuzzi NS, Delanois RE. Presentation of Knee Osteoarthritis in the Emergency Department: A Problem Worth Mentioning? Surg Technol Int. 2017 Dec 22;31:277-284.
- Ragab, A.R., Hegab, S., Elnemr, R. et al. Intra-articular corticosteroid injection and genicular nerve block under ultrasound guidance in pain control of knee osteoarthritis. Egypt J Radiol Nucl Med. 52, 196 (2021).
- Kim DH, Choi SS, Yoon SH, Lee SH, Seo DK, Lee IG, Choi WJ, Shin JW. Ultrasound-Guided Genicular Nerve Block for Knee Osteoarthritis: A Double-Blind, Randomized Controlled Trial of Local Anesthetic Alone or in Combination with Corticosteroid. Pain Physician. 2018 Jan;21(1):41-52.
- Dunworth S, Gadsden J. How I do it: genicular nerve blocks for acute pain. ASRA Pain Medicine News. 2022;47.
- Sobel J, Oswald J. Novel Use of 3-Point Genicular Nerve Block for Acute Knee Pain in the Emergency Department. J Emerg Med. 2021 Oct;61(4):416-419. Epub 2021 Jun 25.
- Kong C, Bubic IJ, Tran AA, Tan G, Medak AJ, Oswald J. Genicular nerve block for emergency department patient: a successful management of subacute osteoarthritic knee pain. Pain Manag. 2023 Jul;13(7):373-378. Epub 2023 Jul 17.
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