Genicular nerve block for emergency knee pain
Ultrasound-Guided Genicular Nerve Block for Knee Pain in the Emergency Department: A Randomized Controlled Trial
This test compares a genicular nerve block plus usual care to standard emergency care to try to reduce pain for adults with atraumatic knee pain and no large effusion on X-ray.
Quick facts
| Phase | Not applicable |
|---|---|
| Study type | Interventional |
| Enrollment | 34 (estimated) |
| Ages | 18 Years and up |
| Sex | All |
| Sponsor | University of Pennsylvania Academic / other |
| Locations | 4 sites (Philadelphia, Pennsylvania and 3 other locations) |
| Trial ID | NCT07158736 on ClinicalTrials.gov |
What this trial studies
This randomized interventional trial enrolls adults (>17 years) presenting to participating Philadelphia emergency departments with atraumatic knee pain, an ED knee X-ray without fracture or a large effusion, and an initial pain score of 5–10. Participants are randomized to receive a genicular nerve block with bupivacaine and corticosteroid or standard of care in the ED. The study will track short-term pain relief, analgesic requirements in the ED, and procedure-related adverse events, with planned brief follow-up to capture ongoing pain outcomes. Key exclusions include suspected septic joint, prior knee replacement on the affected side, allergy to local anesthetics, pregnancy, hemodynamic instability, or inability to consent.
Who should consider this trial
Good fit: Adults over 17 who present to one of the participating Penn EDs with atraumatic knee pain, have an ED knee X-ray showing no fracture or large effusion, and report an initial pain score of 5–10 are the intended participants.
Not a fit: Patients with a fracture or large effusion on X-ray, suspected septic joint, prior knee replacement of the affected knee, allergy to local anesthetics, pregnancy, incarceration, or inability to consent are unlikely to benefit or be eligible.
Why it matters
Potential benefit: If successful, the procedure could provide faster and more effective short-term pain relief in the emergency department and reduce the need for systemic opioids.
How similar studies have performed: Prior studies of genicular nerve blocks for chronic knee pain and osteoarthritis have shown some pain relief, but randomized data for their use in the emergency department for acute atraumatic knee pain are limited.
Eligibility criteria
Show full inclusion / exclusion criteria
Inclusion Criteria: * Atraumatic knee pain * \>17 years age * X-ray of the knee obtained in the ED * Initial pain score (numeric rating scale) 5-10 Exclusion Criteria: * Fracture or dislocation on x-ray * large knee joint effusion identified on x-ray * allergy or contraindication to local anesthetics * History of local anesthetic systemic toxicity after receiving local anesthetics * Pregnancy * Incarcerated * History of knee replacement of affected knee * Concern for septic joint * Overlying cellulitis * Hemodynamic instability * Altered mental status or inability to consent for procedure.
Where this trial is running
Philadelphia, Pennsylvania and 3 other locations
- Hospital of the University of Pennsylvania — Philadelphia, Pennsylvania, United States (Recruiting)
- Pennsylvania Hospital — Philadelphia, Pennsylvania, United States (Recruiting)
- Pennsylvania Presbyterian Medical Center — Philadelphia, Pennsylvania, United States (Recruiting)
- HUP Cedar — Philadelphia, Pennsylvania, United States (Recruiting)
Study contacts
- Principal investigator: Michael M Shalaby, MD — University of Pennsylvania
- Study coordinator: Umar Clinical Research Coordinator, AB
- Email: umar.aulia@pennmedicine.upenn.edu
- Phone: 267-624-4394
How to participate
- Review the eligibility criteria above with your treating physician.
- Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
- Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.