Complex regional pain syndrome of the knee after conventional radiofrequency ablation of the genicular nerves treated successfully with dorsal root ganglion stimulation: A case report

Pain Pract. 2022 Jun;22(5):541-546. doi: 10.1111/papr.13115. Epub 2022 May 18.

Abstract

Background: Radiofrequency (RF) treatment of the genicular nerves offers pain relief in patients suffering from chronic knee pain including persistent post-surgical knee pain (PPSP). We present the first case report of the development of complex regional pain syndrome (CRPS) in a chronic knee pain patient after an RF ablation of the genicular nerves that was successfully treated with dorsal root ganglion (DRG) stimulation.

Case presentation: The patient developed increased pain, sympathetic and dysmorphic changes of the index knee 10 weeks after RF treatment for PPSP. Diagnosis of CRPS type II was made using positive clinical findings and the Budapest diagnostic tool. Laboratory workup and PET-CT were negative. The patient was refractory to usual care and she was treated successfully with dorsal ganglion root stimulation.

Conclusions: Complex regional pain syndrome is a possible complication of RF ablation of the genicular nerves in patients with chronic knee pain, and DRG stimulation may be a treatment option. Physicians should be aware of this complication, especially when patients have a medical history of CRPS.

Keywords: DRG stimulation; chronic knee pain; complex regional pain; genicular nerves; radiofrequency ablation.

Publication types

  • Case Reports

MeSH terms

  • Arthralgia / etiology
  • Arthralgia / therapy
  • Catheter Ablation / adverse effects*
  • Complex Regional Pain Syndromes / etiology
  • Complex Regional Pain Syndromes / therapy*
  • Female
  • Ganglia, Spinal / diagnostic imaging
  • Ganglia, Spinal / physiology*
  • Humans
  • Osteoarthritis, Knee / complications*
  • Pain / surgery
  • Positron Emission Tomography Computed Tomography
  • Transcutaneous Electric Nerve Stimulation*