Osteoarthritis, Knee
Conditions
Keywords
genicular nerve, osteoarthritis, knee, neurotomy
Brief summary
Chronic osteoarthritis (OA) pain of the knee is not effectively abrogated by the available non-pharmacologic or pharmacologic treatments. Radiofrequency (RF) neurotomy is a therapeutic alternative for chronic pain. Here, the researchers investigate the efficacy of RF neurotomy applied to articular branches (genicular nerves) in treating knee joint pain.
Detailed description
The knee joint is innervated by articular branches of various nerves (femoral, common peroneal, saphenous, tibial and obturator) (Kennedy et al. 1982; Hirasawa et al. 2000). These articular branches around the knee joint are known as genicular nerves. Several genicular nerves can be easily approached percutaneously under fluoroscopic guidance. In our study, genicular nerves were effectively blocked with local anesthetics under fluoroscopic guidance, leading to a significant reduction in knee pain. Rf neurotomy is based on the theory that cutting the nerve supply to a painful structure may alleviate pain and restore function. we evaluate the efficacy of RF neurotomy in reducing pain and improving function in the elderly with chronic knee OA.
Interventions
PROCEDUREradiofrequency neurotomy for genicular nerve
RF cannula was advanced percutaneously towards areas connecting the shaft to epicondyle of femur or tibia. Lidocaine (1 mL of 2%) was injected before activation of the RF generator (NeuroThermTM, Morgan automation LTD, Liss, UK). RF electrode was inserted through RF cannula. The temperature of the electrode tip was raised to 70℃ for 90 seconds by radiofrequency generator.
PROCEDUREradiofrequency neurotomy sham therapy
The placebo (sham) group received the same procedure without activation of the RF generator.
Sponsors
Asan Medical Center
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Subject)
Eligibility
Sex/Gender
ALL
Age
50 Years to 80 Years
Healthy volunteers
Yes
Inclusion criteria
* patients with chronic knee pain (i.e., knee pain of moderate intensity or greater on most or all days for ≥ 3 months) * patients with radiologic knee osteoarthritis (Kellgren-Lawrence grade 2-4, evaluated by a radiologist)
Exclusion criteria
* acute knee pain * prior knee surgery * other connective tissue diseases affecting the knee * serious neurologic or psychiatric disorders * injection with steroids or hyaluronic acids during the previous 3 months * sciatic pain * anticoagulant medications * pacemakers * prior electroacupuncture treatments
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Visual analogue scale pain scores | at 12 weeks after the procedure |
Secondary
| Measure | Time frame |
|---|---|
| Oxford knee score | at 12 weeks after the procedure |
Countries
South Korea
Outcome results
None listed