Comparative Evaluation of the Effectiveness of Adductor Canal Block versus Conservative Treatment for the Management of Anteromedial Knee Pain in Knee Osteoarthritis: A Prospective Study

Abstract

Abstract Context: Knee osteoarthritis (KOA) is the most common type of lower extremity osteoarthritis (OA), with pain being the predominant symptom, leading to significant morbidity and impaired quality of life. Objectives: This study was designed to ascertain the effectiveness of ultrasound-guided adductor canal block (ACB), ensuing functional improvement and change in the quality of life in KOA patients with anteromedial knee pain and compare it with conservative treatment. Materials and Methods: A total of 196 patients were recruited for this trial and initially treated conservatively with oral analgesics and exercise. At the end of 2 and 4 weeks from the inclusion date, they were offered a crossover to the intervention with ACB for the saphenous nerve. The outcome measures, such as Visual Analogue Scale (VAS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score, Timed Up and Go test, number of analgesics ingested per day and World Health Organization Quality of Life-BREF (WHOQoL-BREF) scores, were recorded at pre-decided time points. Results: After multiple structured follow-ups, 76 and 86 patients were analysed in the intervention and conservative groups, respectively. The two groups had no significant differences in the demographic and clinical patterns. The intervention group showed improvements in VAS (at week 2) (P < 0.05), WOMAC and the number of analgesics ingested per day (weeks 2 and 4) (P < 0.05). At ‘week 8’ follow-up, most patient outcomes including physical health and psychological domains of WHOQoL-BREF scores were better for conservative group (P < 0.05). The rest of the outcome measures were comparable for both groups at all time points. No adverse events were reported. Conclusion: This study suggests that ACB is effective only for a short duration and does not offer any significant advantage over conservative management in the long run.