Gonartroz Hastalarında Ultrason Eşliğinde Uygulanan Geniküler Sinir Pulsed Radyofrekans Tedavisinin Ağrı ve Diz Fonksiyonlarına Uzun Dönem Etkisi

Amaç Gonatroz, yetişkinlerde kronik diz eklem ağrısına neden olan en yaygın kas-iskelet sistemi hastalığıdır. Geniküler sinirlere radyofrekans uygulanması, uzun etki süresi ve dokuda destrüsyona yol açmaması nedeniyle kronik diz ağrısının tedavisinde giderek popüler hale gelmiştir. Çalışmamızda, konservatif tedavilere yanıt vermeyen, kronik diz ağrılı gonartroz hastalarında, geniküler sinirlere ultrason eşliğinde uygulanan pulsed radyofrekans tedavisinin (GPRF) uzun dönem ağrı ve diz fonksiyonlarına olan etkisini incelemeyi amaçladık.Gereç ve Yöntemler Çalışmaya, Kellgren-Lawrence sınıflamasına göre evre 3-4 gonartroz tanısı almış olan, en az 6 ay boyunca uygulanan konservatif tedavilere rağmen ağrıları geçmeyen hastalar dahil edildi. Geniküler sinirlere ultrason eşliğinde gerçekleştirilen tanısal blok ile VAS skoru %50 ve daha fazla azalan hastalara GPRF uygulandı. Hastaların VAS ve Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) skorları işlem öncesi, işlem sonrası 1, 3, 6 ve 12. ayda değerlendirildi. Bulgular Kriterleri karşılayan 293 hastadan, geniküler sinirlere ultrason eşliğinde uygulanan tanısal bloğa yanıt veren 232 hastaya GPRF uygulandı. Hastaların GPRF öncesi VAS skoru ortalaması 6.77±1.24 iken GPRF sonrası 1, 3, 6 ve 12.ay VAS skoru ortalamaları sırasıyla 2.76±1.14, 2.94±1.08, 3.53±0.64, 4.58±0.75 bulundu. Hastaların GPRF öncesi WOMAC skoru ortalaması 65.75±14.15 iken GPRF sonrası 1, 3, 6 ve 12.ay WOMAC skoru ortalamaları sırasıyla 36.14±13, 36.52±11.06, 37.88±10.86, 41.67±10.84 bulundu. Sonuç Konservatif tedavilere yanıt vermeyen gonartroza bağlı kronik diz eklem ağrısında, ultrason eşliğinde uygulanan GPRF tedavisi, en az 12 ay boyunca ağrıyı azaltmakta ve diz fonksiyonlarını iyileştirmekde etkilidir.

Anahtar Kelimeler:

Gonartroz, pulsed radyofrekans, geniküler sinir, diz ağrısı

Long-term Effects of Ultrasound-guided Genicular Nerve Pulsed Radiofrequency on Pain and Knee Functions in Patients with Gonarthrosis.

Objective: Osteoarthritis of the knee is the most common musculoskeletal disease in older adults which causes chronic knee pain. Pulsed radiofrequency (PRF) on genicular nerves (GN) has become increasingly popular in the treatment of chronic knee pain due to its long duration of action and non-destructive therapy. This study aimed to reveal the effects of ultrasound-guided PRF therapy on GN in patients with knee osteoarthritis (KOA).Materials and Methods: This study included patients, who were diagnosed with gonarthrosis grade 3 to 4 according to the Kellgren-Lawrence classification which patients suffered from intractable knee pain, at least for six months despite conservative treatment. The ultrasound-guided PRF on GN (GPRF) was performed in those patients with a reduction of 50% or more visual analog scale (VAS) score after the diagnostic GN block (GNB). VAS and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores were evaluated before, and 1, 3, 6 and 12 months after the procedure.Results: Of the 293 patients included in the criteria, ultrasound-guided GPRF was administered to 232 patients who responded to GNB. While the mean VAS score of the patients before the GPRF was 6.77 ± 1.24, the mean VAS scores at the 1st, 3rd, 6th and 12th months of the GPRF were 2.76 ± 1.14, 2.94 ± 1.08, 3.53 ± 0.64, and 4.58 ± 0.75, respectively. The mean WOMAC score of the patients before GPRF was 65.75 ± 14.15, while the mean WOMAC score of the 1st, 3rd, 6th and 12th months after GPRF was 36.14 ± 13, 36.52 ± 11.06, 37.88 ± 10.86, and 41.67 ± 10.84, respectively.Conclusion: Ultrasound-guided GPRF therapy in chronic knee pain which does not respond to conservative treatments reduces pain for at least 12 months and is effective improving knee functions.

Keywords:

Gonarthrosis, pulsed radiofrequency, genicular nerve, knee pain,

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