VAS Scores, Pain-Free Duration, Range of Motion, and IL-6 Levels are Better in Adductor Canal Block Compared to Genicular Nerve Block in Patients with Chronic Pain of Degenerative Disease of the Knee Joint
##plugins.themes.bootstrap3.article.main##
Introduction: Chronic knee pain is the leading cause of functional limitations in the older age group and accounts for many visits to health care providers. This degenerative condition is progressive with functional impairment and a severe decrease in quality of life. Pain management with Adductor Canal Block (ACB) and Genicular Nerve Block (GNB) can be an alternative treatment option for chronic knee pain. This study aims to analyze the difference between clinical & laboratory outcomes of the ACB and GNB groups.
Material & Methods: An experimental study with consecutive sampling was conducted on 34 patients with chronic knee pain divided into 2 groups of ACB and GNB procedures. The parameters measured were VAS score, pain-free duration, range of motion, and interleukin-6 (IL-6) levels.
Results: Predominance of chronic knee pain patients found in older women. Based on statistical analysis, there was an improvement in VAS scores (p<0,05), a similar pain-free duration (p>0,05), an improvement in the range of motion (p<0,05), and a decrease in IL-6 levels (p<0,05) significantly in the ACB group compared to GNB.
Conclusion: ACB can be used as an effective therapy in treating chronic knee pain.
Downloads
References
-
Neogi T. The epidemiology and impact of pain in osteoarthritis. Osteoarthritis Cartilage. 2013; 21(9): 1145-1153.
DOI |
Google Scholar
1
-
Kementrian Kesehatan RI. Riset kesehatan dasar riskesdas 2013. Jakarta: Badan penelitian dan pengembangan Kesehatan kementrian Kesehatan RI; 2013. Indonesian.
Google Scholar
2
-
Vaishya R, Pariyo GB, Agarwal AK, Vijay V. Non-operative management of osteoarthritis of the knee joint. Journal of Clinical Orthopaedics and Trauma. 2016; 7(3): 170-176.
DOI |
Google Scholar
3
-
Lee DH, Lee MY, Kwack KS, Yoon SH. Effect of adductor canal block on medial compartment knee pain in patients with knee osteoarthritis: Retrospective comparative study. Medicine (Baltimore). 2017; 96(12): e6374.
DOI |
Google Scholar
4
-
Ragab AR, Hegab S, Elnemr R, Abdel-Kerim A. Intra-articular corticosteroid injection and genicular nerve block under ultrasound guidance in pain control of knee osteoarthritis. Egyptian Journal of Radiology and Nuclear Medicine. 2021; 52(1): 1-7.
DOI |
Google Scholar
5
-
Doo K. 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; 21(1): 41-52.
Google Scholar
6
-
Alecu M, Geleriu L, Coman G, Galatescu L. The interleukin-1, interleukin-2, interleukin-6 and tumour necrosis factor alpha serological levels in localised and systemic sclerosis. Rom J Intern Med. 1998; 36(3-4): 251-9.
Google Scholar
7
-
Jaury DF. Gambaran nilai VAS (Visual Analogue Scale) pasca bedah seksio sesar pada penderita yang diberikan tramadol. eCl [Internet]. 2014; 2(1): 1-5. Indonesian.
DOI |
Google Scholar
8
-
Hamood R, Tirosh M, Fallach N, Chodick G, Eisenberg E, Lubovsky O. Prevalence and incidence of osteoarthritis: a population-based retrospective cohort study. J Clin Med. 2021; 10(18): 4282.
DOI |
Google Scholar
9
-
Vina ER, Kwoh CK. Epidemiology of osteoarthritis: literature update. Curr Opin Rheumatol. 2018; 30(2): 160-167.
DOI |
Google Scholar
10
-
Nguyen US, Zhang Y, Zhu Y, Niu J, Zhang B, Felson DT. Increasing prevalence of knee pain and symptomatic knee osteoarthritis: survey and cohort data. Ann Intern Med. 2011; 155(11): 725-732.
DOI |
Google Scholar
11
-
Fukui N, Yamane S, Ishida S, Tanaka K, Masuda R, Tanaka N, et al. Relationship between radiographic changes and symptoms or physical examination findings in subjects with symptomatic medial knee osteoarthritis: a three-year prospective study. BMC Musculoskelet Disord. 2010; 11: 269.
DOI |
Google Scholar
12
-
Kukreja P, Venter A, Mason L, Kofskey AM, Northern T, Naranje S, et al. Comparison of genicular nerve block in combination with adductor canal block in both primary and revision total knee arthroplasty: a retrospective case series. Cureus. 2021; 13(7): e16712.
DOI |
Google Scholar
13
-
Kim KY, Huh YG, Ma SH, Yoon JH, Jeong KY, Park DY, et al. Efficacy of adductor canal block on medial knee pain in patients with knee osteoarthritis: a randomized single-blind placebo-controlled study. Int J Environ Res Public Health. 2022; 19(22): 15419.
DOI |
Google Scholar
14
-
Rambhia M, Chen A, Kumar AH, Bullock WM, Bolognesi M, Gadsden J. Ultrasound-guided genicular nerve blocks following total knee arthroplasty: a randomized, double-blind, placebo-controlled trial. Reg Anesth Pain Med. 2021; 46(10): 862-866.
DOI |
Google Scholar
15
-
Kim DH, Choi SS, Yoon SH, Lee SH, Seo DK, Lee IG, et al. 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; 21(1): 41-52.
DOI |
Google Scholar
16
-
Tan Z, Kang P, Pei F, Shen B, Zhou Z, Yang J. A comparison of adductor canal block and femoral nerve block after total-knee arthroplasty regarding analgesic effect, effectiveness of early rehabilitation, and lateral knee pain relief in the early stage. Medicine (Baltimore). 2018; 97(48): e13391.
DOI |
Google Scholar
17
-
Pascarella G, Costa F, Del Buono R, Agrò FE. Adductor canal and femoral triangle: Two different rooms with the same door. Saudi J Anaesth. 2019; 13(3): 276-277.
DOI |
Google Scholar
18
-
Woolf CJ. What is this thing called pain?. J Clin Invest. 2010; 120(11): 3742-3744.
DOI |
Google Scholar
19
-
Burckett-St Laurant D, Peng P, Girón Arango L, Niazi AU, Chan VW, Agur A, et al. The nerves of the adductor canal and the innervation of the knee: an anatomic study. Reg Anesth Pain Med. 2016; 41(3): 321-7.
DOI |
Google Scholar
20
-
Sankineani SR, Reddy ARC, Eachempati KK, Jangale A, Gurava Reddy AV. Comparison of adductor canal block and IPACK block (interspace between the popliteal artery and the capsule of the posterior knee) with adductor canal block alone after total knee arthroplasty: a prospective control trial on pain and knee function in immediate postoperative period. Eur J Orthop Surg Traumatol. 2018; 28(7): 1391-1395.
DOI |
Google Scholar
21
-
Tsuchida AI, Beekhuizen M, Rutgers M, van Osch GJVM, Bekkers JEJ, Bot AGJ, et al. Interleukin-6 is elevated in synovial fluid of patients with focal cartilage defects and stimulates cartilage matrix production in an in vitro regeneration model. Arthritis Res Ther. 2012; 14(6): R262.
DOI |
Google Scholar
22
-
Livshits G, Zhai G, Hart DJ, Kato BS, Wang H, Williams FM, et al. Interleukin-6 is a significant predictor of radiographic knee osteoarthritis: The Chingford Study. Arthritis Rheum. 2009; 60(7): 2037-45.
DOI |
Google Scholar
23
-
Tanaka T, Narazaki M, Kishimoto T. IL-6 in inflammation, immunity, and disease. Cold Spring Harbor Perspectives in Biology. 2014; 6(10): 1-10.
DOI |
Google Scholar
24
-
Bianchi M, Broggini M, Balzarini P, Franchi S, Sacerdote P. Effects of nimesulide on pain and on synovial fluid concentrations of substance P, interleukin-6 and interleukin-8 in patients with knee osteoarthritis: comparison with celecoxib. Int J Clin Pract. 2007; 61(8): 1270-7.
DOI |
Google Scholar
25
-
Zhou, YQ, Liu, Z, Liu, ZH, Chen SP, Li M, Shahveranov A, et al. Interleukin-6: an emerging regulator of pathological pain. J Neuroinflammation. 2016; 13: 141.
DOI |
Google Scholar
26
-
Wiegertjes R, van de Loo FAJ, Blaney Davidson EN. A roadmap to target interleukin-6 in osteoarthritis. Rheumatology (Oxford). 2020; 59(10): 2681-2694.
DOI |
Google Scholar
27
-
Schinnerling K, Aguillón JC, Catalán D, Soto L. The role of interleukin-6 signalling and its therapeutic blockage in skewing the T cell balance in rheumatoid arthritis. Clin Exp Immunol. 2017; 189(1): 12-20.
DOI |
Google Scholar
28
Most read articles by the same author(s)
-
I Gusti Lanang Ngurah Agung Artha Wiguna,
Ketut Gede Mulyadi Ridia,
I Ketut Suyasa,
Ida Bagus Gede Arimbawa,
I Gusti Ngurah Indra Wiguna,
Febyan,
Leonardus William Kuswara,
Severe-Rigid Scoliosis Treated by Two-Staged Procedures: A Case Series , European Journal of Medical and Health Sciences: Vol. 5 No. 1 (2023) -
Rizki Zainuraditya,
I Wayan Suryanto Dusak,
I Ketut Suyasa,
I Gede Eka Wiratnaya,
Differences in the Levels of Total Volatile Organic Compound (TVOC) and Formaldehyde in Cigarette Smoke and Electrocautery Produced Smoke in Orthopaedic Surgery at IGNG Ngoerah (Sanglah) Denpasar General Hospital , European Journal of Medical and Health Sciences: Vol. 4 No. 6 (2022) -
Surya Abigamika,
Putu Astawa,
IGN Wien Aryana,
Made Agus Maharjana,
I Ketut Suyasa,
Differences in Carrying Angle, Baumann’s Angle, Anterior Humeral Line and Dash Score between Children in the Age Group of Less than 5 Years and over 5 Years at 3 Months Post Open Reduction Internal Fixation Criss-Cross Wire Fracture Supracondylar Humerus Gartland Type III , European Journal of Medical and Health Sciences: Vol. 5 No. 3 (2023) -
Kadek Gede Bakta Giri,
I Ketut Suyasa,
I. G. N. Wien Aryana,
A. A. Wiradewi Lestari,
I Wayan Juli Semadi,
Administration of Recombinant Platelet Derived Growth Factor-Bb (PDGF-Bb) Intrafracture on Shaft Femur Rat Wistar Performed Osteotomy and Intramedullary Wire Improves Healing Process of Fractures, Collagen Type I And III Levels , European Journal of Medical and Health Sciences: Vol. 4 No. 5 (2022) -
Richard Afandi,
Putu Astawa,
I Gede Eka Wiratnaya,
I Ketut Suyasa,
Elysanti Dwi Martadiani,
I Made Dwijaputra Ayusta,
Made Agus Maharjana,
The Association between Achilles Tendon Elasticity and Pirani Score with The Need for Achilles Tendon Lengthening in Patients with Congenital Talipes Equinovarus Post Ponseti Serial Casting , European Journal of Medical and Health Sciences: Vol. 5 No. 2 (2023) -
Agung Kenji Arnaya,
I Ketut Suyasa,
I Gede Eka Wiratnaya,
I Wayan Juli Sumadi,
Differences in Cell Death and BMP-2 Expression in Core Biopsy Specimens of Malignant Bone Tumors Given Hydrogen Peroxide Compared to Liquid Nitrogen , European Journal of Medical and Health Sciences: Vol. 5 No. 4 (2023) -
I Ketut W. Trisaputra,
K. G. Mulyadi Ridia,
I Ketut Suyasa,
I Gede Eka Wiratnaya,
Yenny Kandarini,
Levels of FGF-23, C-Reactive Protein, Alkaline Phosphatase as A Risk Factor for Renal Osteodystrophy in Chronic Kidney Disease Patients Stage IV-V , European Journal of Medical and Health Sciences: Vol. 5 No. 2 (2023) -
Agung Gde Duta Maha Putra,
I Ketut Suyasa,
Made Bramantya Karna,
Decreased IL-6 Levels more than 9,46 pg/ml and TNF-α Levels more than 14,43 pg/ml as Predictors of Functional Outcome of Oxford Knee Score 6 Weeks Post Total Knee Arthroplasty in Kellgren-Lawrence Grade IV Osteoarthritis Patients , European Journal of Medical and Health Sciences: Vol. 4 No. 6 (2022) -
IGN Bagus Andhika Pramana,
I Ketut Siki Kawiyana,
IGN Wien Aryana,
Putu Astawa,
I Wayan Suryanto Dusak,
I Ketut Suyasa,
Lower Creatine Kinase, IL-6 Levels and Femoral Offset Values Lead to Better Outcome Harris Hip Score Post Bipolar Hemiarthroplasty Surgery Day 14 and Day 30 , European Journal of Medical and Health Sciences: Vol. 5 No. 1 (2023) -
I Gusti Ngurah Indra Wiguna,
Ketut Gede Mulyadi Ridia,
I Gede Eka Wiratnaya,
Ketut Siki Kawiyana,
I Ketut Suyasa,
Anak Agung Gede Priyastana,
Jonathan Andryanto,
Febyan Febyan,
I Dewa Gede Indra Pratama Putra,
Proximal Femoral Cortical Thickness Index as a Predictor of Osteoporosis in Women Aged Over 65 Years Old , European Journal of Medical and Health Sciences: Vol. 6 No. 3 (2024)