RT Journal Article
SR Electronic
T1 Is preoperative genicular radiofrequency ablation effective for reducing pain following total knee arthroplasty? A pilot randomized clinical trial
JF Regional Anesthesia & Pain Medicine
JO Reg Anesth Pain Med
FD BMJ Publishing Group Ltd
SP rapm-2021-102501
DO 10.1136/rapm-2021-102501
A1 Puneet Mishra
A1 David Edwards
A1 Marc Huntoon
A1 Christopher Sobey
A1 Gregory Polkowski
A1 John Corey
A1 Kelly Louise Mishra
A1 Andrew Shinar
A1 Stephen Engstrom
A1 Cassandra Palmer
A1 Stephen Bruehl
YR 2021
UL http://rapm.bmj.com/content/early/2021/07/01/rapm-2021-102501.abstract
AB Background and objective Although total knee arthroplasty (TKA) is an effective treatment for severe knee osteoarthritis (OA), a subset of patients experience significant postoperative pain and dissatisfaction. Several clinical trials support the analgesic benefits of genicular nerve radiofrequency ablation (GN-RFA) for non-operative knee OA, but only one prior trial has examined the effects of this intervention given preoperatively on postoperative outcomes following TKA, showing no analgesic benefit of cooled GN-RFA. The current study evaluated whether conventional thermal GN-RFA performed preoperatively resulted in significant improvements in pain and function following TKA.Methods This was a single-center, prospective, randomized, sham-controlled, double-blinded pilot trial in which patients received either conventional GN-RFA (n=30) or sham (n=30) between 2 and 4 weeks prior to their TKA. Baseline measures were obtained preprocedurally on the day of intervention, with follow-up outcomes obtained preoperatively on the day of surgery, and at 2 and 6 weeks postoperatively.Results Patients receiving GN-RFA showed no significant improvements relative to sham controls in the primary outcome, pain intensity at rest at 6-week follow-up. Secondary outcomes, including pain with ambulation and physical function, also showed no significant differences between groups at any follow-up assessment.Conclusions Conventional GN-RFA of the superior lateral, superior medial, and inferior medial genicular nerves when performed prior to TKA did not provide clinically significant pain relief or improvement in functional status at 2 or 6 weeks postoperatively.Trial registration number NCT02947321.Data are available upon reasonable request. All deidentified participant data are in a REDCap database.