Background and Aims Chronic knee pain secondary to osteoarthritis affects millions of patients worldwide. Radiofrequency ablation (RFA) of genicular nerves is an effective and minimally invasive intervention for chronic knee pain. This report aims to describe the applied technique and evaluate its efficacy for the management of osteoarthritis-induced chronic knee pain.
Methods The study involved ten patients, admitted to the Pain Department of GHAN, complaining about chronic knee pain, clinically unresponsive to conservative treatment. During the procedure, patients were placed supine, with the knee flexed around 30°. Anesthesia was provided with subcutaneous lidocaine over the sites of cannulae insertion. A 100mm, 20-Gauge RF-Cannula (DIROS) with a 10mm active tip was placed percutaneously down to the junction of the femoral shaft and lateral epicondyle (Superion Lateral Genicular N.), another at the medial aspect of the distal femoral diaphysis (Superior Medial Genicular N.) and a third at the junction of the tibial diaphysis and medial condyle (Inferior Medial Genicular N) until bone is contacted. After confirming the correct placement of the cannulae tips via fluoroscopic images and via conduct sensory and motor testing, RF-thermocoagulation was initiated at 75°C for 180 seconds. Then, dexamethasone was injected through cannulae to prevent postprocedural pain and neuritis.
Results Pain intensity was evaluated two weeks and three months post-procedurally, using the pain VAS. All patients referred VAS-score 6/10 in the second week. At 3 months, 9/10 patients referred no pain, while one patient referred VAS-score 4/10.
Conclusions Genicular nerves’ RFA is a safe and efficient intervention for chronic knee pain management.
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