Can the addition of ultrasound-guided genicular nerve block using 5% dextrose water augment the effect of autologous platelet rich plasma in treating elderly patients with knee osteoarthritis?

Content Provider	Europe PMC
Author	Chen, Jean-Lon Chen, Chien-Hung Cheng, Chih-Hsiu Chen, Chih-Chi Lin, Kuan-Yu Chen, Carl P.C.
Copyright Year	2020
Abstract	BackgroundTo investigate whether the addition of injecting 5% dextrose water to the genicular nerves can augment the effect of platelet rich plasma (PRP) injections in treating elderly patients with moderate degree of knee osteoarthritis (OA).MethodsForty-six elderly patients with grade 3 on the Kellgren and Lawrence knee OA grading system were divided into control and genicular nerve block groups. Both groups received 4 milliliters (mL) of PRP injected into the knee joint and 2 mL of PRP to the pes anserinus complex. In the nerve block group, 2 mL of 5% dextrose water was also injected to each genicular nerve. In the control group, normal saline was used to inject the genicular nerves. Proteomic technique of 2-dimensional electrophoresis was used to detect the changes in synovial fluid (SF) protein concentrations. Lequesne Functional Index was used to evaluate knee functional status.ResultsAfter 3 monthly PRP injections, concentrations of SF total protein, and proteins associated with inflammation decreased. Protein concentrations associated with chelation increased. In the nerve block group, improvements in pain and in the functional status of the knee joint lasted up to a period of 6 months. At 1 month and 3 months after the injections, Lequesne Functional Index was less than 7 (a value of 7 or higher indicates knee OA).ConclusionThe concept of combining 5% dextrose water injection to the genicular nerves, and PRP injection into the knee joint and to the pes anserinus complex can be a feasible non-operative conservative treatment option for elderly patients with knee OA.
Related Links	https://europepmc.org/backend/ptpmcrender.fcgi?accid=PMC9038944&blobtype=pdf
ISSN	23194170
Journal	Biomedical Journal [Biomed J]
Volume Number	44
DOI	10.1016/j.bj.2020.08.011
PubMed Central reference number	PMC9038944
Issue Number	6 Suppl 1
Issue Number	6 suppl 1
PubMed reference number	35289285
e-ISSN	23202890
Language	English
Publisher	Chang Gung University
Publisher Date	2020-09-01
Access Restriction	Open
Rights License	This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). © 2020 Chang Gung University. Publishing services by Elsevier B.V.
Subject Keyword	Autologous platelet rich plasma Dextrose water Synovial fluid Genicular nerve Nerve block
Content Type	Text
Resource Type	Article
Subject	Medicine