Knee pain relief with genicular nerve blockage in two brain injured patients with heterotopic ossification

• Published in: Brain injury Vol. 29; no. 13-14; p. 1736
• Main Authors: Adiguzel, Emre, Uran, Ayça, Kesikburun, Serdar, Köroğlu, Özlem, Demir, Yasin, Yaşar, Evren
• Format: Journal Article
• Language: English
• Published: England 06.12.2015
• Subjects: Adolescent; Adult; Brain Injuries - physiopathology; Female; Humans; Knee Joint - innervation; Knee Joint - physiopathology; Male; Nerve Block - methods; Ossification, Heterotopic - diagnostic imaging; Ossification, Heterotopic - therapy; Pain - etiology; Pain Management - methods; Radiography; Range of Motion, Articular; heterotopic ossification; pain; Genicular nerve blockage
• ISSN: 1362-301X
• DOI: 10.3109/02699052.2015.1075171

Heterotopic ossification (HO) is the ectopic bone formation in non-osseous tissues. This study aimed to present two patients with traumatic brain injury (TBI) who had HO in knee joint and pain relief after genicular nerve blockage. Case 1: A 14-year-old patient with TBI was admitted with bilateral knee pain and limited range of motion. Physical examination and x-ray graphics revealed calcification which was diagnosed as HO. Ultrasonography (US) guided genicular nerve blockage was performed to both knees with 2 ml lidocaine and 1 ml betamethasone. VAS of pain was decreased to 30 mm from 80 mm. At 6-month follow-up, VAS of pain was still 30 mm. Case 2: A 29-year-old patient with TBI was admitted for rehabilitation. He had right knee pain and his pain was 80 mm according to VAS. Investigation revealed HO. US guided genicular nerve blockage was performed to the right knee and pain was decreased to 20 mm. US guided genicular nerve blockage can provide pain relief in HO and this technique may be effective and alternative for pain relief in patients with neurogenic knee HO to increase patient's compliance.