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Published on: May 26, 2020
Lower limb kinematics improvement after genicular nerve blockade in patients with knee osteoarthritis: a milestone
Julien Lebleu1, Loic Fonkoue2,3, Eric Bandolo3,4
1Neuro Musculo Skeletal Lab (NMSK), Institut de Recherche Expérimentale et Clinique, Université catholique de Louvain, Secteur des Sciences de la Santé, Avenue Mounier 53, B-1200, Brussels, Belgium. Julien.lebleu@uclouvain.be.
Background:
Genicular nerve blockade is a possible treatment for patients with knee osteoarthritis. Pain relief and improvement in functioning is expected. This procedure could be of major interest for patients in low-income countries where total knee arthroplasty is not available for the population. This study aims at assessing the immediate benefits on pain, gait, and stairs kinematics after a genicular nerve blockade in patients suffering from knee osteoarthritis in Cameroun.
Methods:
A prospective study was carried out on 26 subjects in Cameroun. A genicular nerve blockade was performed on 14 women with painful knee osteoarthritis grade 2-4. Lower limb joint angles were recorded with inertial sensors before and 1 h after injection. Patient-reported outcomes of pain and perceived difficulty were collected, as well as 10 m and 6 min walking tests. A reliability analysis of inertial sensors was performed on a sample of 12 healthy subjects by calculating the intraclass correlation coefficient and the standard error of measurement.
Results:
Pain and perceived difficulty decreased significantly (p < 0.001). Cadence increased significantly in stairs climbing (upstairs: + 7.7 steps/min; downstairs: + 7.6 steps/min). There was an improvement for hip sagittal range of motion during gait (+ 9.3°) and pelvis transverse range of motion in walking upstairs (- 3.3°). Angular speed range of the knee in the sagittal plane and of the hip in the frontal plane increased significantly in stairs descent (+ 53.7°/s, + 94.5°/s).
Conclusions:
This study quantified improvement of gait and stair climbing immediately after a genicular nerve blockade in patients suffering from knee OA in Cameroon. This is the first study objectifying this effect, through wearable sensors.
Trial Registration:
Pan African Clinical Trial Registry, PACTR202004822698484 . Registered 28 March 2020 - Retrospectively registered.
