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Which imaging method should be used for genicular nerve radio frequency thermocoagulation in chronic knee osteoarthritis?

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Abstract

This study aimed to perform genicular nerve RF neurotomy using two different imaging methods, fluoroscopy and ultrasound, and to compare the clinical effects and reliability of the two methods. Fifty patients with osteoarthritis were included in this study. Patients were randomly allocated into group 1 (fluoroscopy imaging) and group 2 (ultrasound imaging). Outcomes were measured using a pain scale (visual analog scale; VAS) and the Western Ontario and McMaster Universities (WOMAC) Index of Osteoarthritis. The application time in the ultrasound group (20.2 ± 6.4 min) was shorter than in the fluoroscopy group (25 ± 4.8 min) (p < 0.05). There was no difference in pain relief and functional status between the ultrasound and fluoroscopy groups. Decrease in VAS score and WOMAC total score in the first and third months was significant in both groups (p < 0.001). GNRFT under ultrasound guidance was easily applicable, safe and dynamic, and required no radiation to achieve the same benefit as the fluoroscopy-guided interventions.

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References

  1. Elliott AL, Kraus VB, Luta G, Stabler T, Renner JB, Woodard J, Dragomir AD, Helmick CG, Hochberg MC, Jordan JM. Serum hyaluronan levels and radiographic knee and hip osteoarthritis in African Americans and Caucasians in the Johnston County Osteoarthritis Project. Arthritis Rheum. 2005;52:105–11.

    Article  CAS  PubMed  Google Scholar 

  2. Zhang W, Moskowitz RW, Nuki G, Abramson S, Altman RD, Arden N, Bierma-Zeinstra S, Brandt KD, Croft P, Doherty M, Dougados M, Hochberg M, Hunter DJ, Kwoh K, Lohmander LS, Tugwell P. OARSI recommendations for the management of hip and knee osteoarthritis, part I: critical appraisal of existing treatment guidelines and systematic review of current research evidence. Osteoarthr Cartil. 2007;15(9):981–1000.

    Article  CAS  PubMed  Google Scholar 

  3. Fitzgerald GK, Hinman RS, Zeni J Jr, Risberg MA, Snyder-Mackler L, Bennell KL. OARSI clinical trials recommendations: design and conduct of clinical trials of rehabilitation interventions for osteoarthritis. Osteoarthr Cartil. 2015;23(5):803–14.

    Article  CAS  PubMed  Google Scholar 

  4. Choi WJ, Hwang SJ, Song JG, et al. Radiofrequency treatment relieves chronic knee osteoarthritis pain: a double-blind randomized controlled trial. Pain. 2011;152:481–7.

    Article  PubMed  Google Scholar 

  5. Bogduk N. Pulsed radiofrequency. Pain Med. 2006;7:396–407.

    Article  PubMed  Google Scholar 

  6. Karaman H, Tüfek A, Kavak GÖ, et al. Intra-articularly applied pulsed radiofrequency can reduce chronic knee pain in patients with osteoarthritis. J Chin Med Assoc. 2011;74:336–40.

    Article  PubMed  Google Scholar 

  7. Neal JM. Ultrasound-guided regional anesthesia and patient safety: an evidence-based analysis. Reg Anesth Pain Med. 2010;35(suppl):S59–67.

    Article  PubMed  Google Scholar 

  8. Lam NC, Petersen TR, Gerstein NS, Yen T, Starr B, Mariano ER. A randomized clinical trial comparing the effectiveness of ultrasound guidance versus nevre stimulation for lateral popliteal-sciatic nerve blocks in obese patients. J Ultrasound Med. 2014;33(6):1057–63.

    Article  PubMed  Google Scholar 

  9. Altman RD. Criteria for classification of clinical osteoarthritis. J Rheumatol. 1991;27(Suppl):10–2.

    CAS  Google Scholar 

  10. Kellgren JH, Lawrence JS. Radiological assessment of osteo-arthrosis. Ann Rheum Dis. 1957;16:494–502.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  11. Bellamy N, Buchanan WW, Goldsmith CH, Campbell J, Stitt LW. Validation study of WOMAC: a health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee. J Rheumatol. 1988;15:1833–40.

    CAS  PubMed  Google Scholar 

  12. Horner G, Dellon AL. Innervation of the human knee joint and implications for surgery. Clin Orthop Relat Res. 1994;301:221–6.

    Google Scholar 

  13. Furtado RN, Pereira DF, da Luz KR, dos Santos MF, Konai MS, Mitraud Sde A, Rosenfeld A, Fernandes Ada R, Natour J. Effectiveness of imaging-guided intra-articular injection: a comparison study between fluoroscopy and ultrasound. Rev Bras Reumatol. 2013;53(6):476–82.

    Article  PubMed  Google Scholar 

  14. Erdine S, Bilir A, Cosman ER, Cosman ER Jr. Ultrastructural changes in axons following exposure to pulsed radiofrequency fields. Pain Pract. 2009;9:407–17.

    Article  PubMed  Google Scholar 

  15. Bellini M, Barbieri M. Cooled radiofrequency system relieves chronic knee osteoarthritis pain: the first case-series. Anaesthesiol Intensive Ther. 2015;47:30–3.

    Article  PubMed  Google Scholar 

  16. Mow VC, Flatyow EL, Ateshian GA. Biomechanics. In: Buckwalter JA, Einhorn TA, Simon SR, editors. Orthopaedic basic science. 2nd ed. Rosemont: American Academy of Orthopaedic Surgeons; 2000. p. 133–80.

    Google Scholar 

  17. Hurwitz DE, Sharma L, Andriacchi TP. Effect of knee pain on joint loading in patients with osteoarthritis. Curr Opin Rheumatol. 1999;11(5):422–6.

    Article  CAS  PubMed  Google Scholar 

  18. Vas L, Pai R, Khandagale N, Pattnaik M. Pulsed radiofrequency of the composite nervesupplytothekneejoint as a new technique for relieving osteoarthritic pain: a preliminary report. Pain Physician. 2014;17:493–506.

    PubMed  Google Scholar 

  19. Weidner S, Kellner W, Kellner H. Interventional radiology and the musculoskeletal system. Best Pract Res Clin Rheumatol. 2004;18(6):945–56.

    Article  PubMed  Google Scholar 

  20. Wagner LK, Eifel PJ, Geise RA. Potential biological effects following high X-ray dose interventional procedures. J Vasc Int Radiol. 1994;5:71–84.

    Article  CAS  Google Scholar 

  21. Guermazi A, Hayashi D, Eckstein F, Hunter DJ, Duryea J, Roemer FW. Imaging of osteoarthritis. Rheum Dis Clin North Am. 2013;39(1):67–105.

    Article  PubMed  Google Scholar 

  22. Narouze S. Ultrasonography in pain medicine: a sneak peak at the future. Pain Pract. 2008;8:223–5.

    Article  PubMed  Google Scholar 

  23. Narouze SN. Ultrasound-guided interventional procedures in pain management: evidence-based medicine. Reg Anesth Pain Med. 2010;35(2 Suppl):S55–8.

    Article  PubMed  Google Scholar 

  24. De Maeseneer M, Marcelis S, Boulet C, Kichouh M, Shahabpour M, de Mey J, Cattrysse E. Ultrasound of the knee with emphasis on the detailed anatomy of anterior, medial, and lateral structures. Skeletal Radiol. 2014;43(8):1025–39.

    PubMed  Google Scholar 

  25. Liu SS, John RS. Modeling cost of ultrasound versus nerve stimulator guidance for nerve blocks with sensitivity analysis. Reg Anesth Pain Med. 2010;35(1):57–63.

    Article  PubMed  Google Scholar 

  26. Liu SS, Ngeow J, John RS. Evidence basis for ultrasound-guided block characteristics: onset, quality, and duration. Reg Anesth Pain Med. 2010;35(2 Suppl):S26–35.

    Article  PubMed  Google Scholar 

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Acknowledgments

We thank Dr. Sezen Ozkisacik for the original picture (Fig. 1).

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Authors and Affiliations

  1. Adnan Menderes University Medical Faculty, Anesthesiology and Reanimation Department, Aydin, Turkey

    Sinem Sarı, Selda Şen & Ferdi Gulastı

  2. Adnan Menderes University Medical Faculty, Algology Department, Aydin, Turkey

    Osman Nuri Aydın & Pınar Özlülerden

  3. Adnan Menderes University Medical Faculty, Physical and rehabilitation Department, Aydin, Turkey

    Yasemin Turan

  4. Adnan Menderes University Medical Faculty, Biostatistics Department, Aydin, Turkey

    İmran Kurt Ömürlü

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  1. Sinem Sarı
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  2. Osman Nuri Aydın
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  5. Pınar Özlülerden
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Correspondence to Sinem Sarı.

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The authors Sinem Sarı M.D., Osman Nuri Aydın M.D., FIPP, Yasemin Turan MD, Selda Şen M.D., Pınar Özlülerden MD, İmran Kurt Ömürlü PhD, Ferdi Gulastı MD declare that they have no conflicts of interest.

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Sarı, S., Aydın, O.N., Turan, Y. et al. Which imaging method should be used for genicular nerve radio frequency thermocoagulation in chronic knee osteoarthritis?. J Clin Monit Comput 31, 797–803 (2017). https://doi.org/10.1007/s10877-016-9886-9

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  • DOI: https://doi.org/10.1007/s10877-016-9886-9

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