Zafer Yasin KONYA, Suna Akın TAKMAZ, Hülya BAŞAR, Bülent BALTACI, Gülçin BABAOĞLU

Results of genicular nerve ablation by radiofrequency in osteoarthritis-related chronic refractory knee pain

Background/aim: The aim of this study was to investigate the medium- to long-term effects of radiofrequency RF ablation of genicular nerves for chronic refractory knee pain due to osteoarthritis OA .Materials and methods: Forty-eight patients who underwent RF ablation of the genicular nerves were evaluated retrospectively. The visual analogue scale VAS score, Western Ontario and McMaster universities osteoarthritis index WOMAC index , opioid and nonsteroidal antiinflammatory drug NSAID use score, quality of life score, and treatment satisfaction score were examined at 1, 3, and 6 months after the procedure.Results: The mean VAS scores were significantly lower at the 1-, 3-, and 6-month evaluations compared with the preoperative values P

Keywords:

Knee osteoarthritis, pain, genicular nerves, radiofrequency ablation,

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1. Felson DT. Epidemiology of hip and knee osteoarthritis. Epidemiologic Reviews 1988; 10: 1-28. doi: 10.1093/ oxfordjournals.epirev.a036019
2. Neogi T. The epidemiology and impact of pain in osteoarthritis. Osteoarthritis Cartilage. 2013; 21(9): 1145-1153. doi: 10.1016/j. joca.2013.03.018
3. Van Saase JL, Van Romunde LK, Cats A, Vandenbroucke JP, Valkenburg HA. Epidemiology of osteoarthritis: Zoetermeer survey. Comparison of radiological osteoarthritis in a Dutch population with that in 10 other populations. Annals of the Rheumatic Diseases 1989; 48 (4): 271-280.
4. Michael JW, Schlüter-Brust KU, Eysel P. The epidemiology, etiology, diagnosis, and treatment of osteoarthritis of the knee. Deutsches Ärzteblatt International 2010; 107(9): 152-162. doi:10.3238/arztebl.2010.0152
5. Ruangsomboon P, Chareancholvanich K, Harnroongroj T, Pornrattanamaneewong C. Survivorship of medial opening wedge high tibial osteotomy in the elderly: two to ten years of follow up. International Orthopaedics 2017; 41(10): 2045-2052. doi: 10.1007/s00264-017-3517-z
6. Yang LM. Treatment of medial compartment knee osteoarthritis by arthroscopic ‘L’ medial release procedure. International Orthopaedics 2017; 41: 2025-2035. doi: 10.1007/ s00264-017-3508-0
7. Al-Mohrej OA, Alshammari FO, Aljuraisi AM, Bin Amer LA, Masuadi EM et al. Knowledge and attitude towards total knee arthroplasty among the public in Saudi Arabia: a nationwide population-based study. International Orthopaedics 2018; 42 (4): 819-827. doi: 10.1007/s00264-017-3743-4
8. Diehl P, Gerdesmeyer L, Schauwecker J, Kreuz PC, Gollwitzer H et al. Conservative therapy of osteoarthritis. Der Orthopade 2013; 42 (2): 125-139. doi: 10.1007/s00132-012-2016-6
9. Choi WJ, Hwang SJ, Song JG, Leem JG, Kang YU et al. Radiofrequency treatment relieves chronic knee osteoarthritis pain: a double-blind randomized controlled trial. Pain 2011; 152 (3): 481-487 doi: 10.1016/j.pain.2010.09.029
10. Qudsi-Sinclair S, Borrás-Rubio E, Abellan-Guillén JF, Padilla Del Rey ML, Ruiz-Merino G. A comparison of genicular nerve treatment using either radiofrequency or analgesic block with corticosteroid for pain after a total knee arthroplasty: a doubleblind, randomized clinical study. Pain Practice 2017; 17 (5): 578-588. doi: 10.1111/papr.12481
11. Kırdemir P, Çatav S, Alkaya Solmaz F. The genicular nerve: radiofrequency lesion application for chronic knee pain. Turkish Journal of Medical Sciences 2016; 47 (1): 268-272. doi: 10.3906/sag-1601-171
12. Iannaccone F, Dixon S, Kaufman A. A review of long-term pain relief after genicular nerve radiofrequency ablation in chronic knee osteoarthritis. Pain Physician 2017; 20 (3): E437-E444.
13. El-Hakeim EH, Elawamy A, Kamel EZ, Goma SH, Gamal RM et al. Fluoroscopic guided radiofrequency of genicular nerves for pain alleviation in chronic knee osteoarthritis: a singleblind randomized controlled trial. Pain Physician 2018; 21 (2): 169-177.
14. Ikeuchi M, Ushida T, Izumi M, Tani T. Percutaneous radiofrequency treatment for refractory anteromedial pain of osteoarthritic knees. Pain Medicine 2011; 12 (4): 546-551. doi: 10.1111/j.1526-4637.2011.01086.x
15. Santana Pineda MM, Vanlinthout LE, Moreno Martín A, Van Zundert J, Rodriguez Huertas F et al. Analgesic effect and functional improvement caused by radiofrequency treatment of genicular nerves in patients with advanced osteoarthritis of the knee until 1 year following treatment. Regional Anesthesia and Pain Medicine 2017; 42 (1): 62-68. doi: 10.1097/ AAP.0000000000000510
16. Sarı S, Aydın ON, Turan Y, Özlülerden P, Efe U et al. Which one is more effective for the clinical treatment of chronic pain in knee osteoarthritis: radiofrequency neurotomy of the genicular nerves or intra-articular injection? International Journal of Rheumatic Diseases.2018; 21 (10): 1772-1778. doi: 10.1111/1756-185X.12925
17. Bellini M, Barbieri M. Cooled radiofrequency system relieves chronic knee osteoarthritis pain: the first case-series. Anaesthesiology Intensive Therapy 2015; 47 (1): 30-33. doi: 10.5603/AIT.2015.0003
18. McCormick ZL, Korn M, Reddy R, Marcolina A, Dayanim D et al. Cooled radiofrequency ablation of the genicular nerves for chronic pain due to knee osteoarthritis: six-month outcomes. Pain Medicine 2017; 18 (9): 1631-1641. doi: 10.1093/pm/ pnx069
19. McCormick ZL, Reddy R, Korn M, Dayanim D, Syed RH et al. A prospective randomized trial of prognostic genicular nerve blocks to determine the predictive value for the outcome of cooled radiofrequency ablation for chronic knee pain due to osteoarthritis. Pain Medicine 2018 ; 19 (8): 1628-1638. doi: 10.1093/pm/pnx286
20. Kennedy JC, Alexander IJ, Hayes KC. Nerve supply of the human knee and its functional importance. The American Journal of Sports Medicine 1982; 10 (6): 329-335. doi: 10.1177/036354658201000601
21. Tüzün EH, Eker L, Aytar A, Daşkapan A, Bayramoğlu M. Acceptability, reliability, validity and responsiveness of the Turkish version of WOMAC osteoarthritis index. Osteoarthritis Cartilage 2005; 13 (1): 28-33. doi: 10.1016/j.joca.2004.10.010
22. Sluijter ME, Teixeira A, Serra V, Balogh S, Schianchi P. Intraarticular application of pulsed radiofrequency for arthrogenic pain—report of six cases. Pain Practice 2008; 8 (1): 57-61. doi: 10.1111/j.1533-2500.2007.00172.x
23. Kesikburun S, Yaşar E, Uran A, Adigüzel E, Yilmaz B. Ultrasound-guided genicular nerve pulsed radiofrequency treatment for painful knee osteoarthritis: a preliminary report. Pain Physician 2016; 19 (5): E751-E759.
24. Karaman H, Tüfek A, Kavak GÖ, Yildirim ZB, Uysal E et al. Intra-articularly applied pulsed radiofrequency can reduce chronic knee pain in patients with osteoarthritis. Journal of the Chinese Medical Association 2011; 74 (8): 336-340. doi: 10.1016/j.jcma.2011.06.004
25. Eyigor C, Eyigor S, Akdeniz S, Uyar M. Effects of intra-articular application of pulsed radiofrequency on pain, functioning and quality of life in patients with advanced knee osteoarthritis. Journal of Back and Musculoskeletal Rehabilitation 2015; 28 (1): 129-134. doi: 10.3233/BMR-140500
26. Gupta A, Huettner DP, Dukewich M. Comparative effectiveness review of cooled versus pulsed radiofrequency ablation for the treatment of knee osteoarthritis: a systematic review. Pain Physician 2017; 20 (3): 155-171.
27. Franco CD, Buvanendran A, Petersohn JD, Menzies RD, Menzies LP. Innervation of the anterior capsule of the human knee: implications for radiofrequency ablation. Regional Anesthesia and Pain Medicine 2015; 40 (4): 363-368. doi: 10.1097/AAP.0000000000000269
28. McCormick ZL, Walega DR. Third-degree skin burn from conventional radiofrequency ablation of the inferiomedial genicular nerve. Pain Medicine 2018; 19 (5): 1095-1097. doi: 10.1093/pm/pnx204
29. Mata J, Valenti P, Hernández B, Mir B, Aguilar JL. Study protocol for a randomised controlled trial of ultrasoundguided pulsed radiofrequency of the genicular nerves in the treatment of patients with osteoarthritis knee pain. BMJ Open. 2017; 7 (11): e016377. doi: 10.1136/bmjopen-2017-016377