Background and Aims Knee osteoarthritis (OA) is a major cause of disability with growing impact in a more aging society. Conservative therapies have shown limited efficacy. After Total knee arthroplasty 15% to 30% of patients continue experiencing pain.
Radiofrequency ablation of genicular nerves is effective in relieving pain. Bony landmarks under fluoroscopic guidance have been used but, ultrasound is an alternative without any radiation exposure and visualization of genicular arteries and tendons.
Pulsed radiofrequency, is a safe causing neuromodulation of sensitive fibers without nerve damage, effective in neuropathic pain and better tolerated during treatment.
Methods A number of 3 patients with chronic knee pain and unsuccessful treatments were submitted to US-guided PRF of the superior medial, superior lateral, and inferior medial genicular nerves. The landmarks used where an adaptation of those described by Fonkoue L, et al.1 in their anatomic study. The Brief Pain Inventory (BPI) and Western Ontario and McMaster Universities Osteoarthritis (WOMAC) scores were assessed before treatment, and at 30 days following the procedure.
Results All patients had a similar severity pain baseline – mean WOMAC score of 78.6 (range 75–81) and mean VAS score of 69 (range 65–72). All patients had a reduction of perceived pain and functionality with improvement of 35% in WOMAC score (mean 51.3) and 50.7% in BPI score (mean 35). No adverse outcomes reported.
Conclusions Our preliminary results suggest that US-guided PRF of genicular nerves is a safe and effective procedure that alleviates pain in patients with severe degenerative disease and we intend to continue to improve the technique.
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