A retrospective study on patients with chronic knee pain treated with ultrasound‐guided radiofrequency of the genicular nerves (RECORGEN trial)

Belba, Amy; Vanneste, Thibaut; Kuijk, Sander M J van; Mesotten, Dieter; Mestrum, Roel; Boxem, Koen Van; Lantschoot, Astrid Van; Bellemans, Johan; Velde, Marc Van de; Zundert, Jan Van

doi:10.1111/papr.13088

Cited by 7 publications

(2 citation statements)

References 35 publications

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“…When comparing the findings of this trial with the literature, we remark that treatment success in this study is lower. Earlier studies demonstrate treatment success (proportion ≥50% pain reduction) of a conventional RF between 32% and 59% at 3 months and after a cooled RF between 61% and 74% at 6 months 12 13 28 29. First, this difference could be explained by the fact that no prognostic block was used in this trial.…”

Section: Discussionmentioning

confidence: 92%

Comparison of cooled versus conventional radiofrequency treatment of the genicular nerves for chronic knee pain: a multicenter non-inferiority randomized pilot trial (COCOGEN trial)

Vanneste

Belba

Kallewaard

et al. 2023

Reg Anesth Pain Med

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BackgroundRadiofrequency (RF) treatment of the genicular nerves has the potential to reduce chronic knee pain due to osteoarthritis or persistent postsurgical pain, however, a direct comparison between the two main modalities used, conventional and cooled, is lacking.MethodsThis double blind, non-inferiority, pilot, randomized controlled trial compared the effects of cooled and conventional RF in chronic knee pain patients suffering from osteoarthritis or persistent postsurgical pain after total knee arthroplasty. Patients were randomized following a 1:1 rate. The primary outcome was the proportion of patients with ≥50% pain reduction at 3 months postintervention. Other outcomes were knee pain, functionality, quality of life, emotional health, and adverse events up to 6 months postintervention. Conventional RF treatment was tested for non-inferiority to cooled in reducing knee pain at 3 months follow-up.ResultsForty-nine of 70 patients were included, of which 47 completed a 3-month follow-up. The primary outcome was achieved in 4 of 23 patients treated with conventional RF (17%) vs in 8 of 24 with cooled (33%) (p=0,21). Results from the non-inferiority comparison were inconclusive in relation to the non-inferiority margin. There was no statistically significant difference between secondary outcomes. There were no serious adverse events.ConclusionsBoth conventional and cooled RF treatment reduced pain in the osteoarthritis and persistent postsurgical pain population. This pilot study did not demonstrate statistically significant differences in the proportion of patients experiencing ≥50% pain reduction between techniques. The non-inferiority analysis was inconclusive. These results warrant further research.Trial registration numberNCT03865849.

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Section: Discussionmentioning

confidence: 92%

Comparison of cooled versus conventional radiofrequency treatment of the genicular nerves for chronic knee pain: a multicenter non-inferiority randomized pilot trial (COCOGEN trial)

Vanneste

Belba

Kallewaard

et al. 2023

Reg Anesth Pain Med

Self Cite

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“…The Retrospective Study on Patients with Chronic Knee Pain Treated with Ultrasound-Guided Radiofrequency of the Genicular Nerves reported by Belba et al . was a retrospective single-centre cohort study of individuals treated with ultrasound-guided conventional RF of the genicular nerves for chronic knee pain ( 59 ). The outcome parameters were GPE, VNRS for pain, consumption of strong opioids, and safety of management at 6 weeks and cross-sectionally at a variable time point.…”

Section: Lower Limb Rf Treatmentsmentioning

confidence: 99%

Upper limb and lower limb radiofrequency treatments in orthopaedics

2023

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Radiofrequency (RF) is a minimally invasive technique for disrupting or altering nociceptive pathways to treat musculoskeletal neuropathic and nociplastic pain. RF has been employed to treat painful shoulder, lateral epicondylitis, knee and hip osteoarthritis, chronic knee pain, Perthes disease, greater trochanteric pain syndrome, plantar fasciitis, and painful stump neuromas; it has also been employed before and after painful total knee arthroplasty and after anterior cruciate ligament reconstruction. The benefits of RF include the following:it is safer than surgery; there is no need for general anaesthesia, thereby reducing adverse effects; it alleviates pain for a minimum of 3–4 months; it can be repeatable if necessary; and it improves joint function and minimizes the need for oral pain medication. RF is contraindicated for pregnant women; unstable joints (hip, knee, and shoulder); uncontrolled diabetes mellitus; presence of an implanted defibrillator; and chronic joint infection (hip, knee, and shoulder). Although adverse events from RF are unusual, potential complications can include infection, bleeding, numbness or dysesthesia, increased pain at the procedural site, deafferentation effect, and Charcot joint neuropathy. Although there is a risk of damaging non-targeted neural tissue and other structures, this can be mitigated by performing the technique under imaging guidance (fluoroscopy, ultrasonography, and computed tomography). RF appears to be a valuable technique for alleviating chronic pain syndromes; however, firm proof of the technique’s efficacy is still required. RF is a promising technique for managing chronic musculoskeletal of the limbs pain, particularly when other techniques are futile or not possible.

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Selective Sensory Denervation by Means of Radiofrequency (RF) Ablation: a Novel Non-surgical Treatment Approach in Chronic Joint Pain: a Narrative Review on Its Application on Knee Hip and Shoulder

Tinnirello¹,

Santi

Haag

2022

SN Compr. Clin. Med.

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A retrospective study on patients with chronic knee pain treated with ultrasound‐guided radiofrequency of the genicular nerves (RECORGEN trial)

Cited by 7 publications

References 35 publications

Comparison of cooled versus conventional radiofrequency treatment of the genicular nerves for chronic knee pain: a multicenter non-inferiority randomized pilot trial (COCOGEN trial)

Comparison of cooled versus conventional radiofrequency treatment of the genicular nerves for chronic knee pain: a multicenter non-inferiority randomized pilot trial (COCOGEN trial)

Upper limb and lower limb radiofrequency treatments in orthopaedics

Selective Sensory Denervation by Means of Radiofrequency (RF) Ablation: a Novel Non-surgical Treatment Approach in Chronic Joint Pain: a Narrative Review on Its Application on Knee Hip and Shoulder

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