GENicular Nerve Block in KNEE Arthroplasty

Summary

The goal of this clinical trial is to learn whether a preoperative genicular nerve block (GNB) can reduce pain after knee replacement surgery in adults with knee osteoarthritis (OA) undergoing total knee arthroplasty (TKA). It will also assess whether this treatment can reduce opioid use and improve recovery.

The main questions it aims to answer are:

* Does a preoperative GNB reduce pain during movement 24 hours after surgery compared with placebo?
* Does it reduce opioid consumption and improve physical activity and functional outcomes after surgery?

Researchers will compare patients receiving a GNB to patients receiving a placebo injection to see if the nerve block improves postoperative pain and recovery.

Participants will:

* Be randomly assigned to receive either a GNB or a placebo injection before surgery
* Undergo standard knee replacement surgery and postoperative care
* Report pain levels at regular intervals after surgery
* Complete questionnaires on function, quality of life, and recovery
* Wear an activity monitor to measure physical activity after surgery
* Attend follow-up assessments at 1 week, 1 month, and 3 months

Conditions

• Osteoarthritis (OA) of the Knee
• Total Knee Arthroplasty
• Genicular Nerve Block

Interventions

PROCEDURE

Preoperative genicular nerve block (GNB)

Participants randomized to the intervention group will receive a preoperative ultrasound-guided genicular nerve block prior to surgery. The procedure is performed under sterile conditions by an experienced anesthesiologist using ultrasound guidance to identify anatomical landmarks. A local anesthetic (ropivacaine 5 mg/mL) is injected at three sites targeting the sensory innervation of the knee joint: the superolateral, superomedial, and inferomedial genicular nerves. A volume of 5 mL is administered at each site, for a total of 15 mL. If the accompanying genicular artery is not visualized, the injection is performed at the corresponding bony landmark. The intervention is administered once before surgery in addition to standard perioperative care, including spinal anesthesia, multimodal analgesia, and local infiltration analgesia during surgery.

PROCEDURE

Placebo nerve block

Participants randomized to the placebo group will receive a preoperative ultrasound-guided placebo nerve block prior to surgery. The procedure is performed under sterile conditions by an experienced anesthesiologist using ultrasound guidance to identify anatomical landmarks. 5 mL of 0.9% normal saline is injected at three sites targeting the sensory innervation of the knee joint: the superolateral, superomedial, and inferomedial genicular nerves. A volume of 5 mL is administered at each site, for a total of 15 mL. If the accompanying genicular artery is not visualized, the injection is performed at the corresponding bony landmark. The intervention is administered once before surgery in addition to standard perioperative care.

Sponsors & Collaborators

• The Nordmøre and Romsdal Hospital Trust

  collaborator UNKNOWN

• St. Olavs Hospital

  collaborator OTHER

• Oslo University Hospital

  collaborator OTHER

• Helse Møre og Romsdal HF

  lead OTHER_GOV

Principal Investigators

• Tommy Frøseth Aae, MD, PhD · Department of orthopedic surgery, Nordmøre and Romsdal Hospital, Møre and Romsdal Hospital Trust, Norway

Study Design

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

QUADRUPLE

Model

PARALLEL

Eligibility

Min Age

18 Years

Max Age

80 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2026-06-01

Primary Completion

2028-06-01

Completion

2029-06-01

Countries

• Norway

Study Locations