Knee Osteoarthritis, Knee Pain Chronic
Conditions
Keywords
Fast-Track Total Knee Arthroplasty, Genicular Nerve Block, Radiofrequency Ablation
Brief summary
In our study, investigators plan to compare the preoperative RF and genicular nerve ablation approach in patients who underwent TKA(Total Knee Arthroplasty) using the Fast-Track protocol in terms of meeting postoperative pain, function and early discharge criteria.
Detailed description
One of the most important components of surgery using Fast-Track is the application of effective and well-monitored pain treatment. Post-surgical pain negatively affects the patient's early mobilization. Reduction in pain after TKA(Total Knee Arthroplasty) may not only increase short-term functional results but also increase the patient's overall satisfaction. Genicular Nerve Radiofrequency Ablation (GNRFA) is a non-surgical treatment increasingly used in patients with advanced knee osteoarthritis. Previous studies have shown this to be an effective and safe method to reduce pain and improve functionality in this patient population. Neurolysis of genicular nerves with radiofrequency (RF) may be useful to relieve pain and improve both function and quality of life in patients with post-TKA pain. Investigators thought that reducing the pain of patients who underwent TKA with Fast-track in the postoperative period would contribute to early mobilization and therefore rapid functional recovery. As a result of previous studies, investigators know that genicular nerve neurolysis with RF Ablation in the preoperative period provides a reduction in postoperative pain. Investigators routinely apply TKA applications in clinic with Fast-Track. In investigators hospital's algology outpatient clinic, genicular nerve RF ablation is routinely performed under USG or fluoroscopy guidance. In investigators study, investigators plan to compare the preoperative RF and genicular nerve ablation approach in patients who underwent TKA using the Fast-Track protocol in terms of meeting postoperative pain, function and early discharge criteria
Interventions
PROCEDUREGenicular nerve Radiofrequency Ablation block
Genicular nerve Radiofrequency Ablation block
Sponsors
Pamukkale University
Study design
Observational model
CASE_CONTROL
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
40 Years to 85 Years
Healthy volunteers
No
Inclusion criteria
* Being between the ages of 40 and 85, * Being able to understand verbal and written information given in Turkish, * Being able to speak and understand Turkish, * Being subjected to unilateral TKA surgery due to the diagnosis of Primary Knee osteoarthritis
Exclusion criteria
* Patients planned for revision knee prosthesis surgery, * Patients previously diagnosed with psychiatric disorders, * Patients who have undergone major surgery on the extremity where TKA will be applied, * Patients with comorbid diseases such as rheumatoid arthritis or cancer, * Patients with a score above 3 according to the American Society of Anesthesiologists (ASA) scoring, * Patients with neurological diseases that cause functional disability, * Patients with flexion limitation of more than 45 degrees and extension limitation of more than 20 degrees, * Patients who have to use hypnotic or anxiolytic drugs regularly, * Patients with alcohol or drug addiction, * Patients with bleeding disorders * Patients with uncontrolled diabetes
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Length of hospital stay | through study completion, an average of 1 year | Length of hospital stay is measured beginning from the hospitalization of the patient and ending at discharge of the patients (unit-hours) |
| Performance-based activity limitations-preoperative 1 | at postoperative sixth weeks | 30-sec chair-stand test and stair-climb test are used |
| Performance-based activity limitations-preoperative 2 | at postoperative twelfth week | 30-sec chair-stand test and stair-climb test are used |
| Quality of life-preoperative 2 | at postoperative twelfth week | Short Form-36 (SF-36) is used |
| Quality of life-preoperative | Baseline (preoperatively) | Short Form-36 (SF-36) is used |
| Quality of life-preoperative 1 | at postoperative sixth weeks | Short Form-36 (SF-36) is used |
| Pain preoperative | Baseline (preoperatively) | Visual Analog Scale used to assess pain |
| Pain postoperative 1 | at postoperative sixth weeks | Visual Analog Scale used to assess pain |
| Pain postoperative 2 | at postoperative twelfth weeks | Visual Analog Scale used to assess pain |
| Knee Range of Motion preoperative | Baseline (preoperatively) | Digital goniometer used to assess knee range of motion |
| Knee Range of Motion postoperative 1 | at postoperative sixth week | Digital goniometer used to assess knee range of motion |
| Knee Range of Motion postoperative 2 | at postoperative twelfth week | Digital goniometer used to assess knee range of motion |
| Quadriceps muscle strength preoperative | Baseline (preoperatively) | Quadriceps muscle strength is measured (unit=newton(N)) with hand-held dynamometer |
| Quadriceps muscle strength postoperative 1 | at postoperative sixth weeks | Quadriceps muscle strength is measured (unit=newton(N)) with hand-held dynamometer |
| Quadriceps muscle strength postoperative 2 | at postoperative twelfth week | Quadriceps muscle strength is measured (unit=newton(N)) with hand-held dynamometer |
| Patient-reported activity limitations preoperative | Baseline (preoperatively) | The Western Ontario and McMaster Universities Arthritis Index and Knee injury and Osteoarthritis Outcome Score are used |
| Patient-reported activity limitations preoperative 1 | at postoperative sixth weeks | The Western Ontario and McMaster Universities Arthritis Index and Knee injury and Osteoarthritis Outcome Score are used |
| Patient-reported activity limitations preoperative 2 | at postoperative twelfth week | The Western Ontario and McMaster Universities Arthritis Index and Knee injury and Osteoarthritis Outcome Score are used |
| Performance-based activity limitations-preoperative | Baseline (preoperatively) | 30-sec chair-stand test and stair-climb test are used |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Length of operation time | the surgery | Length of operation time is measured in minutes during the surgery |
| Amount of blood loss | through study completion, an average of 1 year | Amount of blood loss is measured from the suction drainage (unit-milliliters) |
| postoperative component alignments | through study completion, an average of 1 year | Long leg radiographs of the patients are evaluated postoperatively by using a digital orthopedic templating software-Materialise OrthoView (OrthoView version 7, Materialise HQ, Technologielaan 15 3001 Leuven, Belgium). |
Countries
Turkey (Türkiye)
Contacts
Primary ContactHARUN R GUNGOR, MD
Backup ContactMURAT I KIRBAS, MD
Outcome results
None listed