Examining the Feasibility of Radiofrequency Treatment for Chronic Knee Pain After Total Knee Arthroplasty

Abstract

Recently, investigators began using radiofrequency to manage knee osteoarthritis pain in patients at high risk who cannot undergo surgical intervention. To our knowledge, no study has investigated the use of radiofrequency ablation of the genicular nerves to alleviate chronic knee pain after total knee replacement. A single case is presented here in which genicular nerve ablation successfully improved pain and restored function. We believe that these preliminary results could be used in the development of future prospective cohort studies and randomized controlled trials that focus on the use of radiofrequency ablation to treat persistent knee pain after total knee replacement.

Cooled radiofrequency system relieves chronic knee osteoarthritis pain: the first case-series

“…Only a few papers have investigated the use of radiofrequency ablation of the genicular nerves to alleviate chronic knee pain after total knee replacement [9]: our study showed a positive relief in two out of three patients.…”

Bipolar Radiofrequency Ablation of Genicular Nerves in Patients with Pacemaker

“…8,9 As other techniques to manage chronic knee pain have been found unsatisfactory in terms of prolonged pain relief 10 and RFA of genicular nerves found effective not only in patients waiting for knee replacement 1,2,11 but also even in patients who continue to have pain after arthroplasty. 12 Our patients made us to think 'out-of-the-box' to use bipolar RFA in presence of pacemaker but need for pain relief by RFA of genicular nerves. We used bipolar thermoablation technique wherein both RFA cannulas were kept approximately 10 mm away from each other and RFA was done at 80°C temperature for 90 seconds and RF cannula were rotated by 180° after completion of first cycle to get wide and consistent lesions.…”

Application of cooled radiofrequency ablation in management of chronic joint pain

“…These nerves innervate the knee joint through 5 branches of genicular nerves: superomedial, superolateral, inferomedial, inferolateral, and medial retinacular. [68][69][70][71][72][73] Nonarthroplasty treatment options for this pain conditions include conservative medical management, lifestyle changes, rehabilitation, alternative medicine, intraarticular injections, mechanical interventions, and nonarthroplasty surgical interventions. All these treatment options have variable success rate in different patient populations and different stages of the disease.…”