Korean J Pain 2023; 36(2): 195-207
Published online April 1, 2023 https://doi.org/10.3344/kjp.22325
Copyright © The Korean Pain Society.
Selin Guven Kose1 , Halil Cihan Kose2
, Feyza Celikel3
, Serkan Tulgar4
, Omer Taylan Akkaya2
1Department of Pain Medicine, Health Science University Gaziler Physical Therapy and Rehabilitation Training and Research Hospital, Ankara, Turkiye
2Department of Pain Medicine, Health Science University Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkiye
3Department of Physical Therapy and Rehabilitation, Sakarya Training and Research Hospital, Sakarya, Turkiye
4Department of Anesthesiology and Reanimation, Samsun University Faculty of Medicine, Samsun Training and Research Hospital, Samsun, Turkiye
Correspondence to:Selin Guven Kose
Department of Pain Medicine, Health Science University Gaziler Physical Therapy and Rehabilitation Training and Research Hospital, Ankara 06800, Turkiye
Tel: +90 535 8419952, Fax: +90 312 2911009, E-mail: selinguven89@gmail.com
Handling Editor: Seong-Soo Choi
Received: September 28, 2022; Revised: December 8, 2022; Accepted: December 13, 2022
This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Background: This study aimed to compare the effectiveness of the pericapsular nerve group (PENG) block and intra-articular injection (IAI) of steroid-bupivacaine in the treatment of hip osteoarthritis (OA).
Methods: After randomization, patients received either a PENG block or IAI under ultrasound-guidance. Clinical evaluations were recorded at baseline, day 1, and weeks 1, 4, and 8 post-intervention. The numerical rating scale (NRS), Western Ontario and McMaster Universities Arthritis Index (WOMAC), Harris Hip Scale (HHS) scores, pain medication use determined by a quantitative analgesic questionnaire, and patient satisfaction were evaluated.
Results: Sixty patients were included in this study. NRS scores improved significantly for both groups during the follow-up compared to pretreatment (P < 0.001), with better pain scores for the PENG group (P < 0.001) at day 1 with larger effect size (Cohen’s d = 4.62), and IAI group at 4 (Cohen’s d = 5.15) and 8 (Cohen’s d = 4.33) weeks (P < 0.001). There was no significant difference in pain medication consumption (P = 0.499) and patient satisfaction (P = 0.138) between groups. Patients in the IAI group experienced significant improvement in HHS (Cohen’s d = 2.16, P = 0.007) and WOMAC (Cohen’s d = 1.02, P = 0.036) scores at 8 weeks compared to the PENG group.
Conclusions: The ultrasound-guided PENG block provides effective pain relief which improves functionality and quality of life in hip OA patients up to 2 months. The PENG block can be considered an easy, safe, and useful alternative treatment modality for hip OA.
Keywords: Chronic Pain, Hip, Injections, Intra-Articular, Osteoarthritis, Hip, Pain Management, PENG Block, Quality of Life, Steroids, Ultrasonography, Interventional.