Transcutaneous Pulse Radiofrequency Treatment for Knee Pain

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The aim of this follow-on study is to determine if a transcutaneous pulse radiofrequency treatment can provide useful pain relief in patients with complex knee pain awaiting knee arthroplasty. Knee pain is a common problem with 19-23% prevalence in people aged between 40 and 79 years. An earlier study has shown some patients awaiting knee replacement surgery obtain good pain relief and functional improvement from selective nerve blocks lasting several weeks or months. This however still leaves a significant number of patients experiencing pain while waiting for surgery and other strategies need to be explored. Favourable outcomes have been reported from case series of transcutaneous pulse radiofrequency treatment described in conference proceedings and the literature. Transcutaneous PRF is a painless, non-invasive, non-destructive, needle-free alternative treatment that applies a pulsing electrical field around the target nerve using TENS electrodes that ‘stuns’ rather than destroys the nerve, rendering the nerve incapable of transmitting pain signals. It is not known how transcutaneous PRF works, however, it is thought to induce long lasting biochemical changes in the target spinal nerves without disrupting sensation or motor function. Treatment can be repeated if there is a good response to the first transcutaneous PRF. 40 knee arthroplasty waiting list patients rating their knee pain =5/10 on a verbal rating scale will be invited to participate in a DBRPC trial of transcutaneous pulse radiofrequency treatment. Patients with awaiting a revision hip replacement, with hip or ankle pain interfering with walking, terminal cancer, unable to communicate in English or don’t want to participate will be excluded. The outcome will be determined by comparing pre and post transcutaneous pulse radiofrequency treatment self report questionnaires and objective physical measures

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