Resumo

RAMIREZ OGALLA, I.; MORENO MARTIN, A.; SANTANA PINEDA, M.M.  e  RODRIGUEZ HUERTAS, F.. Effectiveness of genicular nerve radiofrequency treatment in knee osteoarthritis chronic pain. Rev. Soc. Esp. Dolor [online]. 2014, vol.21, n.4, pp.212-218. ISSN 1134-8046.  https://dx.doi.org/10.4321/S1134-80462014000400005.

Introduction: Knee osteoarthritis is a common joint disease in the elderly characterized by pain, stiffness and functional limitation, and daily life disability. Objective: The purpose of this study was to assess the outcome in terms of pain, functional recovery, and side effects during six month of radiofrequency treatment applied to the articular nerve branches (genicular nerves) in patients with chronic knee pain. As secondary outcome we investigated pharmacological therapy reduction and patient's satisfaction after treatment. Material and methods: This prospective, uncontrolled study involved 16 elderly patients with severe knee osteoarthritis pain after genicular nerve radiofrequency treatment. Visual analogic scale (VAS) was measured at baseline (before treatment), at one, three and six months post-procedure. For measurement of functional limitation we used the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) before treatment, and three and six months after procedure. Treatment response was defined as at least 50 % of VAS reduction. We also registered patient's satisfaction after treatment. Results: We included 16 patients with severe knee osteoarthritis pain lasting more than three months, VAS score higher than 5, severe osteoarthritis in Kellgren-Lawrence classification (3-4) and pain resistant to conventional care. We found significant differences in the mean VAS value before radiofrequency 7 (6-8) and after one 3,5 (1-6), three 3,3 (1-7) and six months 3,37 (1-8) after treatment. 75 % of patients had 50% of VAS score reduction after one month, 68,75 % of patients after three months and 65 % of patients after six months (p = 0,009). Moreover, we also found significant differences in WOMAC score mean values before treatment 65,8 (54-79) and after three 54,7 (41-67) and six 50,3 (37-69) months after radiofrequency. No patient reported a post-procedure adverse event during de follow-up period. Conclusions: RF application to genicular nerves showed significant benefit in terms of pain reduction and functional improvement in a 6 month follow-up in patients with chronic knee osteoarthritis and thus may be an effective treatment in such cases. Further trials with larger sample size and longer follow-up are needed.

Palavras-chave : Radiofrequency; Knee; Osteoarthritis; Chronic pain; Genicular nerve.

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