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Abstract
Background and Aims A 75 years old man, with no significant past medical history, in 2012 underwent surgical procedure of tumor excision and knee-replacement with a megaprosthesis. After the intervention, good pain relief was obtained. In 2017 the patient was successfully treated for a periprostheric infection with no recurrency. In 2020, the Patient started experiencing an intense chronic knee pain that limited his ability to walk and be self-sufficient. No benefit by medical therapy.
Methods After a first saphenous test block with lidocaine, which resulted in short-term significant reduction of pain, we proceded to the implantation. In an operating theatre, under ultrasound guidance, we identified the saphenous nerve in the adductor canal and placed the device close to it. Once the optimal frequencies to ensure good knee coverage have been set, the lead was fixed in position with stitches. A pocket device ensured the control of the stimulation by the patient.
Results After the implantation: the Womac Pain Index decrease from 60 to 25, Womac function from 58 to 20. In BPI scale: pain intensity passed from 6 to 3 and pain interference from 7 to 2.NO peri-operative
Conclusions This novel wireless neurostimulator proved effective in controlling a chronic knee pain, improving person’s quality of life. The absence of a required subcutaneous unit is a clear advantage for the managing of this device, especially in the outpatient setting. However, it needs to be implanted by expert operators and requires a careful follow-up.