Background and Aims Chronic knee oseoarthritis(OA) is a progressive multifactorial disease, and the pain and loss of function are the predominant clinical presentations, Advances in targeting anatomical landmarks using US devices provides more accurate placement of the needle and updates in revised anatomical targets can maximize the efficacy of genicular nerve blocks. Herein we report a revised US guided 5 genicular nerves technique for the treatment of chronic knee pain.

Methods We performed revised US guided 5 genicular nerves technique in five patients with chronic knee pain due to OA. In addition to the most targeted nerves including the superior medial, superior lateral and inferior medial genicular nerves; the recurrent fibular nerve and the infrapatellar branch of the saphenous nerve are targeted by using high-frequency (6–13 Hz) linear transducer. For each target, a fluid mixture of 2 mL: bupivacaine%0.25 and 4 mg dexamehasone was administered.

Results The mean NRS score declined from 7.6±1.14 to 3.2±1.3, 3.2±1.3 to 1.6±0.54 at in movement and at rest, respectively, at 3 months. Also, all patients WOMAC scores have improved (Table 1).

Conclusions In this report, we showed that the revised 5 genicular nerve technique provided pain relief and improved functional capacity in patients with chronic knee pain due to knee OA for 3 months after the procedure.