Radiofrequency- a fancy new treatment for osteoarthritis?
Chronic knee pain can be a disabling condition. There is a new treatment where the small sensory nerves to the knees are stunned with radiofrequency energy. The traditional approach to knee pain is a steroid injection. The issue with multiple steroid injections is that the steroids can impact glucose levels especially in diabetics and the steroids can weaken the knees.
This study demonstrates the improved effectiveness of the “radiofrequency neurotomy” or stunning of the small painful knee nerves.
The Research
Int J Rheum Dis. 2016 Aug 12. doi: 10.1111/1756-185X.12925. [Epub ahead of print]
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?
Sarı S1, Aydın ON2, Turan Y3, Özlülerden P2, Efe U1, Kurt Ömürlü İ4.
Abstract
OBJECTIVES:
To compare the efficacy of intra-articular injection and radiofrequency (RF) neurotomy of genicular nerves in patients with chronic knee osteoarthritis (OA) pain.
METHODS:
Seventy-three patients with knee OA were included in the study. Patients were randomly assigned to Group IA (intra-articular 2.5 mL of bupivacaine, 2.5 mg of morphine and 1 mL of betamethasone, 6 mL of fluid injection) or Group RF (RF neurotomy of the genicular nerves). The outcome measures included a pain scale (visual analog scale, VAS) and Western Ontario and McMaster Universities (WOMAC) Index of Osteoarthritis.
RESULTS:
No statistically significant difference was found between the two groups in baseline VAS-pain. In Group RF, a significant reduction was observed in VAS-pain at the first month (P < 0.001) and the third month (P < 0.001) in comparison to Group IA. Also in Group RF, a significant reduction was observed in WOMAC total scores in the first month (P < 0.001) in comparison to Group IA.
CONCLUSION:
This study is the first controlled study in the literature which compares RF genicular nerve to intra-articular injections. This study demonstrated that genicular nerve RF neurotomy is a safe and efficient treatment modality and provides functional improvement along with an analgesia in patients with chronic knee OA.
