scholarly journals Fluoroscopy -guided genicular nerves pulsed radiofrequency for chronic knee pain treatment

Author(s):  
Şule Arıcan
2017 ◽  
Vol 3 (20;3) ◽  
pp. 197-206 ◽  
Author(s):  
Ersel Gulec

Background: Chronic knee pain is a major widespread problem causing significant impairment of daily function. Pulsed radiofrequency has been shown to reduce severe chronic joint pain as a non-pharmacological and less invasive treatment method. Objective: We aimed to compare the effectiveness of unipolar and bipolar intraarticular pulsed radiofrequency methods in chronic knee pain control. Study Design: Prospective, randomized, double-blind study. Setting: Pain clinic in Cukurova University Faculty of Medicine. Methods: One hundred patients, aged 20 – 70 years with grade 2 or 3 knee osteoarthritis were included in this study. Patients were randomly allocated into 2 groups to receive either unipolar (group U, n = 50) or bipolar (group B, n = 50) intraarticular pulsed radiofrequency (IAPRF) with a 45 V voltage, 2 Hz frequency, 42° C temperature, 10 msec pulse width, and 10 minute duration. We recorded visual analog scale (VAS) and Western Ontario and McMaster Universities Osteoarthritis Index LK 3.1WOMAC (Western Ontario and McMaster Universities Osteoarthritis Index LK 3.1) scores of patients at baseline and one, 4, and 12 weeks after the procedure. The primary outcome was the percentage of patients with ≥ 50% reduction in knee pain at 12 weeks after the procedure. Results: There was a significant difference between the groups according to VAS scores at all post-intervention time points. In group B, 84% of patients, and in the group U, 50% of patients achieved at least 50% knee pain relief from the baseline to 3 months. In group B, WOMAC scores were significantly lower than the group U at one and 3 months. Limitations: Lack of long-term clinical results and supportive laboratory tests. Conclusion: Bipolar IAPRF is more advantageous in reducing chronic knee pain and functional recovery compared with unipolar IAPRF. Further studies with longer follow-up times, laboratorybased tests, and different generator settings are required to establish the clinical importance and well-defined mechanism of action of PRF. This study protocol was registered at clinicaltrials.gov (identifier: NCT02141529), on May 15, 2014. Institutional Review Board (IRB) approval date: January 16, 2014, and number: 26/9 Key words: Chronic pain, intraarticular, knee joint, knee osteoarthritis, pain management, pulsed radiofrequency treatment, quality of life, recovery of function


2013 ◽  
Vol 27 (6) ◽  
pp. 935-938 ◽  
Author(s):  
Rubén E. Djibilian Fucci ◽  
Javier Pascual-Ramírez ◽  
Alino Martínez-Marcos ◽  
Jose M. Valverde Mantecón

Author(s):  
YB Molero Díez ◽  
R Sanchis Dux ◽  
FA Ruíz Simón ◽  
ME Michel Tactuk ◽  
Á Sánchez Tabernero ◽  
...  

Author(s):  
Miguelina Eugenia Michel Tactuk ◽  
Raquel Sanchis Dux ◽  
Yaiza Beatriz Molero Díez ◽  
Álvaro Sánchez Tabernero ◽  
Montserrat García Castaño ◽  
...  

2016 ◽  
Vol 5;19 (5;19) ◽  
pp. E751-E759 ◽  
Author(s):  
Dr. Serdar Kesikburun

Background: Genicular nerve ablation with radiofrequency (RF) has recently emerged as a promising treatment in the management of osteoarthritis related knee pain. To date, genicular nerve injections have been performed under fluoroscopic guidance. Objective: To evaluate the effect of ultrasound-guided genicular nerve pulsed RF treatment on chronic knee pain and function in patients with knee osteoarthritis. Study Design: Single-arm prospective study. Setting: University hospital and rehabilitation center in Turkey. Methods: A review was made of 29 patients with medial knee osteoarthritis who had undergone genicular nerve block in the previous 6 months. Patients with at least 50% reduction in the visual analog scale (VAS) score after genicular nerve block and with no on-going pain relief were selected for the study. Ultrasound-guided genicular nerve pulsed RF was applied to 15 knees of 9 patients. Pain and knee function were assessed with 100-mm VAS and Western Ontario and McMaster Universities (WOMAC) index throughout 3 months. Results: A significant reduction in VAS scores was detected over time after the pulsed RF procedure (f: 69.24, P < 0.01). There was a significant improvement in the WOMAC scores (f: 539.68 , P < 0.01). Limitations: The small number of participants, the lack of a control group, and short followup period were limitations of the study. Conclusions: Genicular nerve pulsed RF treatment has been found to be safe and beneficial in osteoarthritis related knee pain. Further studies with a larger population and randomized controlled study design are warranted to confirm the positive findings of this preliminary report. Key words: Knee pain, osteoarthritis, genicular nerve, ultrasonography, pulsed radiofrequency


2011 ◽  
Vol 74 (8) ◽  
pp. 336-340 ◽  
Author(s):  
Haktan Karaman ◽  
Adnan Tüfek ◽  
Gönül Ölmez Kavak ◽  
Zeynep Baysal Yildirim ◽  
Ersin Uysal ◽  
...  

2020 ◽  
Vol 5;23 (9;5) ◽  
pp. E549-E558
Author(s):  
Peng Yao

Background: Intraarticular pulsed radiofrequency (IAPRF) for the treatment of painful knee osteoarthritis (KOA) is a less invasive treatment method. It has fewer adverse effects and can quickly reduce KOA-related pain and improve knee joint dysfunction. Objectives: We compared the effectiveness of high- and low-voltage IAPRF for the treatment of chronic knee pain. Study Design: Retrospective comparative study design. Setting: This study took place at Shengjing Hospital of China Medical University. Methods: A total of 57 patients with KOA who were hospitalized between July 2018 and July 2019 were randomly allocated into the high-voltage (n = 29) and low-voltage (n = 28) IAPRF groups. IAPRF was performed under the guidance of computed tomography (CT). Numeric Rating Scale (NRS-11), Oxford Knee Score (OKS), degree of pain relief, global perceived effect, and side effects at baseline and 1 week, 2 weeks, 1 month, 3 months, and 6 months after the procedure were recorded and analyzed. Results: NRS-11 scores decreased significantly in both groups after the procedure, but gradually increased after the 6-month follow-up period. There was a significant difference in NRS-11 scores between the 2 groups at all follow-up periods postprocedure. OKS were similar between the 2 groups. Patients with pain relief rate 50% or greater at 1, 3, and 6 months after the procedure accounted for 72.41%, 72.41%, and 55.17% in the high-voltage group, and 46.43%, 46.43%, and 28.57% in the low-voltage group, respectively. The difference between the 2 groups was statistically significant. No significant adverse reactions were observed in the 2 groups, however, patient satisfaction in the high-voltage group was significantly higher compared with patients in the low-voltage group. Limitations: This study was a single-center retrospective study with a relatively small sample cohort and short follow-up period. Conclusions: CT-guided high-voltage IAPRF is more beneficial in reducing knee pain and improving knee function compared with low-voltage IAPRF. In addition, patients who received high-voltage IAPRF were more satisfied with their treatment. Key words: Pulsed radiofrequency, knee osteoarthritis, intraarticular, high voltage, Oxford Knee Score, Numeric Rating Scale


2010 ◽  
Vol 5;13 (5;9) ◽  
pp. 457-467
Author(s):  
Sarani Tong-Ngork

Background: Topical ibuprofen provides an alternative treatment to oral ibuprofen for the treatment of chronic knee pain. Objective: To compare the efficacy of topical versus oral ibuprofen in chronic knee pain treatment. Study Design: Prospective, randomized, unblinded pilot study. Setting: A private pain management practice. Methods: Twenty patients received either ibuprofen tablets 3 times daily (2400 mg total) or 4% topical gel 4 times daily (320 mg total) for 2 weeks. Subjects completed the Western Ontario and McMaster Universities (WOMAC) Osteoarthritis Index, the Medical Outcomes Study 12-Item Short Form (SF-12v2) Health Survey, and a satisfaction questionnaire. Results: Comparison of WOMAC and SF-12v2 mean changes from baseline showed no differences between groups. Patient satisfaction and study treatment convenience were rated equivalently between groups. Within the topical group, significant improvements (P < 0.05) were experienced in the mean differences of WOMAC Pain scores from baseline to 2 weeks (-82.6, -158.3 to -6.8), WOMAC Stiffness scores from baseline to one week (-25.3, -50.0 to -0.6) and baseline to 2 weeks (-47.8, -95.7 to 0.1), WOMAC Physical Function scores from baseline to one week (-175.9, -348.6 to -3.2) and baseline to 2 weeks (-312.1, -580.5 to -43.7), and patient satisfaction scores from baseline to one week and baseline to 2 weeks. Within the oral group, significant improvements (P < 0.05) were experienced in mean differences of WOMAC Physical Function from baseline to one week (-342.6, -638.1 to -47.1) and baseline to 2 weeks (-323.2, -637.1 to -9.2). Limitations: As this was a preliminary investigation, the sample size of 20 subjects is a limitation in this study. Conclusion: Treatment of chronic knee pain with topical ibuprofen provided comparable clinical efficacy and patient satisfaction as oral ibuprofen in this pilot study. Key words: Topical ibuprofen, knee osteoarthritis, chronic pain


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