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B397 Radiofrequency induced genicular nerves neurolysis in management of chronic knee pain: our experience
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  1. I Ktistakis1,
  2. I Chronakis2,
  3. A Vadalouka3,
  4. I Siafaka4 and
  5. E Stavropoulou5
  1. 1General District Hospital of Rethymno, Rethymno Crete, Greece
  2. 2General District Hospital of Rethymno, Rethymno, Crete, Greece
  3. 3Athens Medical centre, Athens, Greece
  4. 4University of Athens, Athens, Greece
  5. 5KAT Hospital, Athens, Greece

Abstract

Background and Aims Radiofrequency (RF) neurolysis as a non-surgical minimally-invasive therapy, has a well described mechanism of action and has been used in a variety of chronic pain conditions. Our aim was to present our six-month experience by the use of RF in the management of chronic pain due to knee osteoarthritis

Methods 18 patients, 12 females and 6 males,78 to 91 years old, with end-stage unilateral knee osteoarthritis were included. Patient’s selection criteria were decided by two consultants, an anesthetist and an orthopedic surgeon.All patients had declined surgical treatment and they all had three or more comorbidities.

Patients underwent an RF ablation for neurolysis of the superior lateral, superior medial, and inferior medial genicular nerves, under radiological guidance. RF lasted 3 minutes for each nerve. Measurement end points included changes in pain and functional scores. Patients were assessed for a short period using the NRS pain score (0 – 10) and a stiffness score (0–20). Additionally complications (bruising, swelling, inflammation, erythema) were recorded as long as patient satisfaction rates.

Results NRS pain scores were decreased by a median of 2 points. Stiffness was decreased by a median of 5 points. 17 out of the 18 patients reported reduced night pain and disturbed sleep . No complications were recorded. 17 patients said they would choose this method again.

Conclusions RF ablation for genicular nerves neurolysis is a viable, safe and a complementary method for patients that are no suitable for surgical treatment of knee osteoarthritis. More studies, preferably randomized controlled trials are needed to confirm these observations.

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