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Analgesic Effect and Functional Improvement Caused by Radiofrequency Treatment of Genicular Nerves in Patients With Advanced Osteoarthritis of the Knee Until 1 Year Following Treatment
  1. María M. Santana Pineda, MD*,
  2. Luc E. Vanlinthout, MD,
  3. Ana Moreno Martín, MD*,
  4. Jan van Zundert, MD, PhD, FIPP,
  5. Fernando Rodriguez Huertas, MD* and
  6. José P. Novalbos Ruiz, MD, PhD§
  1. *Department of Anesthesiology and Pain Medicine at the Jerez de la Frontera General Hospital, Jerez de la Frontera, Affiliated With the University of Cádiz, Cádiz, Spain
  2. Department of Anesthesiology and Pain Medicine at the GZA Hospitals, Antwerp, and Department of Anesthesiology, University Hospital Gasthuisberg, Leuven, Belgium
  3. Multidisciplinary Pain Centre at the Ziekenhuis Oost-Limburg, and Department of Anesthesiology and Pain Management at the Maastricht University Medical Centre, Maastricht, the Netherlands
  4. §Department of Preventive Medicine and Public Health, University of Cádiz, Cádiz, Spain
  1. correspondence: Luc E. Vanlinthout, MD, GZA Hospitals, Sint-Vincentiusstraat 20, 2018 Antwerp, Belgium (e-mail: Vanlinthout.l{at}skynet.be).

Abstract

Background and Objectives Radiofrequency ablation of genicular nerves has proved to be successful in relieving pain and incapacity caused by osteoarthritis of the knee. However, long-term efficacy of such a treatment remains to be assessed. The current study aimed to reproduce radiofrequency neurotomy of genicular nerves to manage gonarthrosis pain and disability and establish therapeutic response until 1 year after intervention.

Methods This single-center, prospective, observational, noncontrolled, longitudinal study included patients with grade 3 to 4 gonarthrosis suffering from intractable knee pain, scoring 5 or more on the visual analog scale (VAS) during >6 months. Therapy was based on ultrasound guided radiofrequency neurotomy of the superior medial, superior lateral and inferior medial genicular nerves. Visual analog scale and Western Ontario and McMaster Universities Osteoarthritis scores were assessed before therapy and at 1, 6, and 12 months following treatment.

Results Radiofrequency neurotomy of genicular nerves significantly reduced perceived pain (VAS) and disability (Western Ontario and McMaster Universities Osteoarthritis) in the majority of participants, without untoward events. The proportion of participants with improvement of 50% or greater in pretreatment VAS scores at 1, 6, and 12 months following intervention were 22/25 (88%), 16/25 (64%) and 8/25 (32%), respectively.

Conclusions Ultrasound-guided radiofrequency neurotomy of genicular nerves alleviates intractable pain and disability in the majority of patients with advanced osteoarthritis of the knee. Such a treatment is safe and minimally invasive and can be performed in an outpatient setting. The beneficial effect of treatment started to decline after 6 months, but even 1 year after the intervention, 32% of patients reported 50% improvement or greater in pretreatment VAS scores.

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Footnotes

  • This study was supported by the Department of Anesthesiology and Pain Medicine of the Jerez de la Frontera General Hospital, Jerez de la Frontera, Affiliated With the University of Cádiz, Cádiz, Spain.

    This work was presented in part at the 13th Ibero-American Pain Congress, May 28-31, 2015, Sevilla, Spain.

    The authors declare no conflict of interest.

    ClinicalTrials.gov identifier NCT02688543

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