Dorsal Root Ganglion Stimulation for Chronic Pain After Total Knee Arthroplasty: A Narrative Review

Rupp, Adam; Char, Steven; Hagedorn, Jonathan M

doi:10.1093/pm/pnab279

Cited by 1 publication

(4 citation statements)

References 10 publications

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“…Furthermore, opioid medication usage reduced drastically. Improvement of pain is in line with other studies that investigated the effects of PNS 8 , 11 , 18 , 20 , 22 .…”

Section: Discussionsupporting

confidence: 90%

“…The results according pain relief are comparable to DRGS and Spinal cord systems 1 , 8 , 23 . Martin et al 11 show a significant improvement of pain in 12 of 14 patients (85%) and a mean reduction in daily morphine dosage of 54% with a mean follow-up time of 24 months using DRG stimulation.…”

Section: Discussionsupporting

confidence: 64%

“…Limited evidence is available today to effectively treat these subjects 7 . Treatment of post-operative pain that is not structural in nature proves to be a challenge for clinical caregivers 8 . Furthermore revision surgeries have limited success rates when performed solely for pain 9 .…”

Section: Introductionmentioning

confidence: 99%

“…Neuromodulation techniques like spinal cord stimulation (SCS) and/or dorsal root ganglion stimulation (DRGS) have been successfully used in the treatment of chronic knee pain 1 , 4 , 8 , 10 , 11 . The evidence involving peripheral nerve stimulation (PNS) is minimal due to the limited number of neuromodulation systems capable of targeting the distal part of lower limbs.…”

Section: Introductionmentioning

confidence: 99%

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Peripheral nerve stimulation for the treatment of chronic knee pain

Früh,

Sargut,

Hussein

et al. 2023

Sci Rep

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The average age of our population is increasing, resulting in a high incidence of chronic degenerative knee pathologies. Several treatment options, including surgical procedures are available to help mitigate these pathologies. However, the percentage of subjects with chronic post-surgical knee pain is still estimated at 16–20%. Neuromodulation techniques such as spinal cord stimulation and dorsal root ganglion stimulation (DRGS) are treatment options for subjects with chronic knee pain. The evidence for peripheral nerve stimulation (PNS) is minimal due to a limited number of neuromodulation systems capable of targeting the distal part of the lower limbs. This study aimed to investigate the safety and efficacy externally powered PNS systems for the treatment of chronic intractable knee pain targeting the saphenous nerve. Patients suffering from chronic intractable post-surgical knee pain received landmark-guided peripheral nerve stimulation of the branches of the saphenous nerve. All implants were performed with an externally powered PNS system to avoid lead migration as a result of cross-joint lead positions tunneling towards an Implantable Pulse Generator to the trunk. Data were collected retrospectively. Subject-reported outcome was measured via numerical rating scale values on a 10-point scale measuring pain intensity at rest and in motion. Additional data were collected for the subjects treated at the Charité location, including quality of life with the SF-36 form, quality of sleep with the Pittsburgh Sleep Quality Index and mood states with the short form of the General Depression Scale. Thirty-three patients received direct to permanent implant, landmark-guided peripheral nerve stimulation of the saphenous nerve branches. Six (18.2%) subjects reported non-sufficient initial benefit from the therapy and were explanted. Two subjects were explanted due to wound infections. The total study population reported included 25 patients. These subjects reported significant improvements related to pain, quality of life, mood quality, and quality of sleep. Additionally, subjects were able to reduce their opioid medication significantly after PNS therapy. Externally powered PNS at the saphenous nerve branches is a straightforward, selective and safe technique for patients with chronic knee pain. The landmark-guided implantation technique is less invasive than classical neuromodulation techniques such as spinal cord or DRGS and complication rates remain low. Short-term results are promising and show considerable reductions in pain scores and opioid intake. Long-term results are pending.

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“…Furthermore, opioid medication usage reduced drastically. Improvement of pain is in line with other studies that investigated the effects of PNS 8 , 11 , 18 , 20 , 22 .…”

Section: Discussionsupporting

confidence: 90%

Section: Discussionsupporting

confidence: 64%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Peripheral nerve stimulation for the treatment of chronic knee pain

Früh,

Sargut,

Hussein

et al. 2023

Sci Rep

View full text Add to dashboard Cite

show abstract

Dorsal Root Ganglion Stimulation for Chronic Pain After Total Knee Arthroplasty: A Narrative Review

Cited by 1 publication

References 10 publications

Peripheral nerve stimulation for the treatment of chronic knee pain

Peripheral nerve stimulation for the treatment of chronic knee pain

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