Genicular Nerve Injection

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Genicular Nerve Injection
Indication Knee Osteoarthritis
Syringe ?
Needle ?
Steroid 20mg triamcinolone optional
Local 6mL
Volume 6mL + steroid


A genicular nerve injection can be used to treat knee osteoarthritis pain with or without steroid. The addition of steroid provides a longer effect but this wanes between 4-8 weeks. With lidocaine alone the effect wanes by 2-4 weeks. However clinically significant relief is only maintained for two weeks. Clinical improvements in functional capacity persist for one week in both options. The use of corticosteroid to enhance a peripheral nerve block remains controversial. [1]


There are three main nerves that supply sensory input to the knee joint. The superior lateral, the superior medial, and the inferior medial genicular nerves.





Ultrasound Guided

  • Position: Supine with pillow under the knee.
  • The genicular nerves (superior lateral, superior medial, and inferior medial) run next to the genicular arteries next to the periosteum of the distal femoral condyle and medial tibial metaphysis.
  • The nerves may be unidentifiable which does not make the procedure contraindicated
  • confirm vessel location using colour doppler.
  • Deposit 2mL next to each genicular artery, for a total of 6mL, plus steroid if using.

Non-ultrasound Guided




See Also

External Links


  1. โ†‘ Kim DH, Choi SS, Yoon SH, 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.

Literature Review