Focus of the Report: This health technology assessment focuses on the use of genicular nerve blocks (GNB) for the management of knee pain associated with osteoarthritis of the knee (KOA) or persistent pain following total knee arthroplasty (TKA).

Technology Description: In a GNB procedure, an anesthetic agent (e.g., lidocaine, bupivacaine) is injected on the genicular nerves of the knee. The procedure specifically targets the superior lateral, superior medial, and inferior medial genicular nerves. Once injected, the anesthesia numbs the nerves and inhibits the transmission of pain signals to the brain.

Controversy: Diagnostic GNB with an anesthetic agent are typically performed to detect the effectiveness of succeeding procedures such as radiofrequency ablation; thus, the duration of effect may wane. The use of an anesthetic agent with adjuvant corticosteroid therapy could contribute to and prolong the analgesic effect of the anesthetic; however, its use has not been well studied and could potentially induce local or systemic adverse effects.

Key Questions:

  • Are GNB effective in treating pain associated with knee pain?

  • How does treatment with GNB compare with clinical alternatives for knee pain?

  • Are GNB safe for treating knee pain?

  • Have definitive patient selection criteria been identified for GNB as a treatment for knee pain?

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