Author/Authors :
Reddy، Rajiv D. نويسنده Department of Physical Medicine and Rehabilitation, The
Rehabilitation Institute of Chicago, Northwestern Feinberg School of
Medicine, Chicago, USA , , McCormick، Zachary L. نويسنده Department of Physical Medicine and Rehabilitation, The Rehabilitation Institute of Chicago, Northwestern Feinberg School of Medicine, Chicago, USA , , Marshall، Ben نويسنده Department of Physical Medicine and Rehabilitation, The
Rehabilitation Institute of Chicago, Northwestern Feinberg School of
Medicine, Chicago, USA , , Mattie، Ryan نويسنده Department of Orthopaedics, Stanford University, Palo Alto, USA , , Walega، David R. نويسنده Department of Anesthesiology, Northwestern Feinberg School
of Medicine, Chicago, USA ,
Abstract :
Chronic knee pain from osteoarthritis (OA) is common in the aging
and the obese population. Radiofrequency ablation of the genicular
nerves has been introduced as a potential surgery-sparing treatment for
chronic knee pain from OA, yet only two outcome studies have been
published and optimal patient selection for this procedure has not been
established. We describe a standardized protocol for selecting patients
for cooled radiofrequency ablation (C-RFA) of the genicular nerves, as
well as the clinical outcomes of four patients ages 63-65 years. The
threshold for selection based on diagnostic genicular nerve block was ≥
80% pain reduction. Following successful block, C-RFA of the genicular
nerves was performed. Outcomes included pain, function, analgesic
medication use, opioid use, and progression to total knee arthroplasty
at a minimum of 6 month follow up. C-RFA of the genicular nerves after
using the described selection protocol resulted in > 90% pain
reduction, improved function and avoidance of surgery at 6 months in all
four cases. All opioid and analgesic medication use decreased or was
unchanged in all cases. No serious adverse events occurred. The
accompanying case series suggests that this protocol is deserving of
randomized, prospective study.
