Case: 57-year-old male patient. Our patient had pain, tingling and burning in the right knee, limitation of motion. VAS was 9-10. He applied to various clinics for this, and an MRI of the right knee was taken. On MRI, an osteochondral lesion with a diameter of approximately 1 cm in the anterior of the femur lateral condyle, a 6 mm diameter joint mouse in the knee joint and volume loss, narrowing in the patella-femoral joint distances were detected. Therefore, direct operation was recommended to this patient, but he applied to our clinic because he did not want the operation. Pregabalin 75mgX2 was started when our patient first applied. He was called for control 15 days later. It was VAS 8-9 when it came to check. Our patient had a lot of pain, but the complaint of burning and tingling decreased, and the limitation of joint movement continued. Thereupon, our patient underwent intra-knee joint injection. Pregabalin 75mgX2 was written and called for control after 21 days. He was VAS 5-6 when he came to check. The burning tingling was almost non-existent, the limitation of movement began to decrease. Popliteal block was added to our patient as an interventional block as well as intra-articular injection of the knee.
Continuation of drug treatment was recommended and he was called for control 21 days later. In the control, the VAS was 3-4. There was no burning and tingling, joint range of motion was reduced by half. In the control, intra-articular injection + popileteal block was applied again. He was asked to continue with the treatment drug and to be checked after 21 days. VAS was 0-1 when he came to check. There was no burning tingling, and there was hardly any limitation of joint movement. Thereupon, the interventional procedures were repeated in our patient. He was advised to continue the drug treatment in the same way, and right knee MRI was requested and he was called for control 21 days later. Our patient’s VAS was 0 when he came to the control. There was no burning tingling or limitation of joint movement.
In MRI, osteochondral lesion was healed, joint mouse shrunk, knee intra-articular fluid increased minimally, improvement was detected in patello-femoral joint distance. Thereupon, we discharged our patient 6 months later to come for control without any interventional procedure.
Conclusion: Here, we have seen that interventional blocks have an important place in the treatment of knee pain. We think that it would be appropriate to perform these blocks before surgery in patients who do not respond to medical treatment for these interventional blocks, and to make a surgical decision in cases that do not respond to these blocks. Interestingly, we see that the pathology in the knee joint is also healed by these interventional blocks. Our work continues to increase such cases.
