Genicular Nerve Injection

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

Background

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.

Anatomy

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.

Technique

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.

See Also

Knee and Leg

Knee and Leg Anatomy

Knee and Leg Conditions

Knee and Leg Procedures

Lower Limb Anatomy

Acute Knee Pain

Calf Pain Differential Diagnoses

Diagnostic Knee Ultrasound

Knee Examination

Knee History

Knee Joint Aspiration

Knee MRI

Knee Pain Differential Diagnoses

Shin Pain

Literature Review

Literature Review

Reviews from the last 7 years: review articles, free review articles, systematic reviews, meta-analyses, NCBI Bookshelf

Articles from all years: PubMed search, Google Scholar search.

TRIP Database: clinical publications about evidence-based medicine.

Other Wikis: Radiopaedia, Wikipedia Search, Wikipedia I Feel Lucky, Orthobullets,