The goal of this prospective randomized control trial is to provide continued pain relief, classically long-lasting 3 to12 months, and enhanced function in patients following: both gender; male and female, age group; \>50yr, healthy volunteers along with Radiographic diagnosis of knee OA with KL grade 3 and 4 in addition of Chronic knee pain ≥ 6 months and patients with ≥50% decrease in pain strength after diagnostic genicular nerve block. The main question it aims to answer is:
Is ultrasound-guided genicular nerve RFA more efficient in lowering pain intensity at six months contrasted with fluoroscopic guided method in patients with chronic knee osteoarthritis? Researchers will compare Group A (Fluoroscopic) to Group B (Ultrasound) to see comparison in efficiency of ultrasound guided against fluoroscopic guided genicular nerves block for decrease in pain intensity and functional improvement.
Both gender patients of age more than 50 years.
Radiographic diagnosis of knee OA with KL level 3 and 4.
Chronic knee pain for more than 6 months
Patients with more than 50% reduction in pain intensity after diagnostic genicular nerve block
Lack of consent
surgery of knee
Patient with BMI more than 40kg/m2
Intra-articular steroid injection or hyaluronic acid in last 3 months
Parallel
Ultrasound Guided
Procedure/SurgeryGenicular nerves radiofrequency ablation will be done with the help of ultrasound guidance.
Fluoroscope Guided
Procedure/SurgeryControl group in which genicular nerves radiofrequency ablation will be done with the help of fluoroscopic guidance.
Effectiveness of Block
Block will be considered effective if decrease in pain score from baseline is \>50% at six months. And this will measure by using the 11-point Numeric Rating Scale (NRS) where 0 = no pain and 10 = worst imaginable pain.
Functional Improvement after block
Functional improvement after genicular nerve block is describe as \> 20 % decrease in KOOS PS score from baseline at six months. Functional condition will be assessed using the Knee injury and osteoarthritis outcomes score-Physical function short form (KOOS-PS) tool. Minimum score is 0 and maximum is 20 which will then be converted into ratio from 0 to 100%, 0 means no functional impairment and 100 means maximum functional impairment.
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