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

Sarı, Sinem; Aydın, Osman Nuri; Turan, Yasemın; Şen, Selda; Özlülerden, Pınar; Ömürlü, İmran Kurt; Gülaştı, Ferdi

doi:10.1007/s10877-016-9886-9

Cited by 33 publications

(25 citation statements)

References 23 publications

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“…As shown in in Figure 3 , knee function was also significantly improved after the treatment of ultrasound-guided RF in patients with OA in six studies [ 23 , 25 , 27 – 30 ]. WOMAC was decreased by 23.155 points (SE: 3.776; 95% CI: −30.556 to −15.753; P < 0.001; I 2 : 97.302%) after the treatment of ultrasound-guided RF compared to that of baseline in patients with OA.…”

Section: Resultsmentioning

confidence: 98%

“…Eighty-four irrelevant studies were removed through screening the titles and abstracts of publications, and 25 additional studies were excluded by exclusion criteria via full-text screening. Finally, eight eligible publications were included in the study of meta-analysis including 3 RCTs, 3 prospective trials, and 2 retrospective studies [ 23 – 30 ]. The screening method and results of the relevant studies are illustrated in Figure 1 .…”

Section: Resultsmentioning

confidence: 99%

“…The primary clinical outcomes for ultrasound-guided RF therapy were pain relief and functional improvement in patients with OA, and the results are shown in Figures 2 and 3 . Significant pain relief was achieved by the treatment of ultrasound-guided RF in 7 studies [ 23 , 24 , 26 – 30 ], and the pooled mean difference of pain score was −4.196 (SE: 0.324; 95% CI: −4.832 to −3.560; P < 0.001; I 2 : 97.894%) compared to that of pretreatment (baseline) in patients with OA ( Figure 2 ).…”

Section: Resultsmentioning

confidence: 99%

“…Moreover, the total time spent on the procedure for ultrasound-guided RF was recorded and compared to that of fluoroscopy-guided RF in the study by Sarı and colleagues [ 23 ]. The duration was 20.2 ± 6.4 min for ultrasonography and 25.0 ± 4.8 min for fluoroscopy, respectively.…”

Section: Resultsmentioning

confidence: 99%

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Efficacy and Safety of Ultrasound-Guided Radiofrequency Treatment for Chronic Pain in Patients with Knee Osteoarthritis: A Systematic Review and Meta-Analysis

Huang

Deng

Yang

et al. 2020

Pain Research and Management

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Background. Knee osteoarthritis (KOA) is a common degenerative disease associated with joint dysfunction and pain. Ultrasound-guided radiofrequency (RF) may be a promising therapy in the treatment of chronic pain for KOA patients. Objective. To evaluate the efficacy and safety of ultrasound-guided RF treatment for chronic pain in patients with KOA. Design. A systematic review was conducted, and a meta-analysis was carried out when possible. Setting. We examined the studies evaluating the clinical efficiency of ultrasound-guided RF on chronic pain in KOA population. Method. A systematic review for the efficacy and safety of ultrasound-guided RF treatment for pain management of KOA patients was carried out in PubMed, EMBASE, Cochrane Library, Web of Science, Wanfang Data, and China National Knowledge Infrastructure (CNKI) from the date of inception to February 2020, and a meta-analysis was conducted. The primary outcomes of pain intensity (visual analogue scale or numerical rating scale) and knee function [the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC)] were evaluated from baseline to various follow-up times by random-effects model. Heterogeneity was assessed by I2 statistic and the potential sources of heterogeneity by subgroup and metaregression analyses, respectively. Results. Eight publications with 256 patients were included in the meta-analysis. RF could relieve pain with −4.196 of pooled mean difference and improve knee function by decreasing 23.155 points in WOMAC. Three patients had ecchymosis, two with hypoesthesia and one with numbness after the procedure, and improved within 6 months. Furthermore, study design and treatment target were the sources of heterogeneity by subgroup and metaregression analyses, accounting for 37% and 74% of variances, respectively. Target of genicular nerve achieved better pain relief than intra-articular or sciatic nerve. Sensitivity analysis showed that removal of any single study was unlikely to overturn the findings. Limitations. There were some limitations in the study. Firstly, the small number of relevant studies limited the confidence level of the meta-analysis. Also, the significant heterogeneity may not be explained due to the limited data. Secondly, the direct comparison of two different guidance methods (ultrasound vs. fluoroscopy) for RF therapy is lacking. In addition, the outcomes were blindly assessed in the meta-analysis from all studies according to evaluation of bias, which could affect the reality of the data. Finally, most of the studies only provided short follow-up times, so we could not analyze the long-term effectiveness of ultrasound-guided RF in the treatment of patients with KOA. Conclusions. Ultrasonography is an effective, safe, nonradiative, and easily applicable guidance method for RF in pain relief and functional improvement in KOA patients.

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Section: Resultsmentioning

confidence: 98%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Efficacy and Safety of Ultrasound-Guided Radiofrequency Treatment for Chronic Pain in Patients with Knee Osteoarthritis: A Systematic Review and Meta-Analysis

Huang

Deng

Yang

et al. 2020

Pain Research and Management

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“…As indicações para o uso da RF no tratamento da gonartrose e as respectivas conclusões dos artigos estão listadas na ►Tabela 1. [25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42][43] Resultados do Procedimento Entre os trabalhos selecionados, os melhores resultados são obtidos nos seis primeiros meses de acompanhamento. McCormick et al 31 relataram completo alívio da dor nesse período.…”

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2019

Rev Bras Ortop

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Palavras-chave ► procedimentos neurocirúrgicos ► ondas de rádio ► rizotomia ► osteoartrite do joelho ► articulação do joelho Resumo A osteoartrite é uma das patologias mais frequentes e incapacitantes na atualidade, principalmente do joelho. Dentre as abordagens possíveis para osteoartrite, a neurotomia dos nervos geniculares por radiofrequência vem se destacando. Todavia, por se tratar de um procedimento relativamente novo, as indicações para realização ainda não estão bem definidas. O principal objetivo desta revisão foi identificar as principais indicações do uso da radiofrequência para o tratamento da osteoartrite do joelho na literatura médica. Foi realizada revisão da literatura em janeiro de 2018, através de pesquisa nas bases de dados PubMed, Clinicalkey e Google Scholar. Após revisão dos principais artigos no assunto, foi concluído que as principais indicações do uso da radiofrequência para o tratamento da osteoartrite do joelho foram: pacientes com osteoartrite grau 3 e 4 da classificação de Kellgren-Lawrence, com dor de moderada a severa e falha do tratamento conservador, principalmente idosos; persistência da dor, mesmo após realizado artroplastia total de joelho; pacientes com indicação de artroplastia total de joelho e que se recusam a submeter-se ao tratamento cirúrgico.

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Anatomical study of the descending genicular artery and implications for image‐guided interventions for knee pain

Fonkoué¹,

Behets²,

Steyaert³

et al. 2020

Clinical Anatomy

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Introduction The descending genicular artery (DGA) has recently been mentioned as accompanying some nerves in the medial aspect of the knee joint. This could be clinically relevant as the arteries could serve as landmarks for accurate nerve capture during ultrasound‐guided nerve blockade or ablation. The aim of this cadaveric study was to investigate the anatomical distribution of the DGA, assess the nerves running alongside its branches, and discuss the implications for regional anesthesia and knee pain interventions. Methods We dissected the femoral artery (FA) all along its course to identify the origin of the DGA, from which we carefully dissected all branches, in 27 fresh‐frozen human specimens. Simultaneously, we systematically dissected the nerves supplying the medial aspect of the knee from proximally to distally and identified those running alongside the branches of the DGA. The surrounding anatomical landmarks were identified and measurements were recorded. Results The DGA was found in all specimens, arising from the FA 130.5 ± 17.5 mm (mean ± SD) proximally to the knee joint line. Seven distribution patterns of the DGA were observed. We found three consistent branches from the DGA running alongside their corresponding nerves at the level of the medial aspect of the knee: the artery of the superior‐medial genicular nerve, the artery of the infrapatellar branch of the saphenous nerve, and the saphenous branch of the DGA. Conclusion The consistent arteries and surrounding landmarks found in this study could help to improve the capture of the targeted nerves during ultrasound‐guided interventions.

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

Cited by 33 publications

References 23 publications

Efficacy and Safety of Ultrasound-Guided Radiofrequency Treatment for Chronic Pain in Patients with Knee Osteoarthritis: A Systematic Review and Meta-Analysis

Efficacy and Safety of Ultrasound-Guided Radiofrequency Treatment for Chronic Pain in Patients with Knee Osteoarthritis: A Systematic Review and Meta-Analysis

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Anatomical study of the descending genicular artery and implications for image‐guided interventions for knee pain

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