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

J Clin Monit Comput. 2017 Aug;31(4):797-803. doi: 10.1007/s10877-016-9886-9. Epub 2016 May 3.

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.

Keywords: Fluoroscopy; Genicular nerve radio frequency thermocoagulation; Knee osteoarthritis; Ultrasonography.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Aged, 80 and over
  • Denervation*
  • Electrocoagulation*
  • Female
  • Fluoroscopy*
  • Humans
  • Knee / innervation*
  • Knee Joint
  • Male
  • Middle Aged
  • Nerve Block
  • Osteoarthritis, Knee / physiopathology
  • Osteoarthritis, Knee / therapy*
  • Pain Management
  • Pain Measurement
  • Prospective Studies
  • Radio Waves
  • Reproducibility of Results
  • Severity of Illness Index
  • Treatment Outcome
  • Ultrasonography*
  • Visual Analog Scale