Interventional radiology techniques for pain reduction and mobility improvement in patients with knee osteoarthritis

Filippiadis, Dimitris; Charalampopoulos, Georgios; Mazioti, Argyro; Alexopoulou, Efthymia; Vrachliotis, Thomas G.; Brountzos, Elias; Kelekis, Nikolaos; Kelekis, Alexis

doi:10.1016/j.diii.2019.02.011

Cited by 28 publications

(22 citation statements)

References 88 publications

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“…However, there are significant contradictions and inconsistencies in the reported clinical results on the efficacy of RF procedures. Most of the clinical studies available in the literature are retrospective studies or case studies limited to reporting high-quality randomized controlled trials [ 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 ]. Furthermore, inappropriate selection criteria and treatment parameters could result in poor treatment outcomes, whereas anatomical variations, which are still not well-established, could limit the accurate interpretation of the obtained results.…”

Section: Clinical Applications Future Outlook and Model Developmementioning

confidence: 99%

Domain Heterogeneity in Radiofrequency Therapies for Pain Relief: A Computational Study with Coupled Models

Singh

Melnik

2020

Bioengineering

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The objective of the current research work is to study the differences between the predicted ablation volume in homogeneous and heterogeneous models of typical radiofrequency (RF) procedures for pain relief. A three-dimensional computational domain comprising of the realistic anatomy of the target tissue was considered in the present study. A comparative analysis was conducted for three different scenarios: (a) a completely homogeneous domain comprising of only muscle tissue, (b) a heterogeneous domain comprising of nerve and muscle tissues, and (c) a heterogeneous domain comprising of bone, nerve and muscle tissues. Finite-element-based simulations were performed to compute the temperature and electrical field distribution during conventional RF procedures for treating pain, and exemplified here for the continuous case. The predicted results reveal that the consideration of heterogeneity within the computational domain results in distorted electric field distribution and leads to a significant reduction in the attained ablation volume during the continuous RF application for pain relief. The findings of this study could provide first-hand quantitative information to clinical practitioners about the impact of such heterogeneities on the efficacy of RF procedures, thereby assisting them in developing standardized optimal protocols for different cases of interest.

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Section: Clinical Applications Future Outlook and Model Developmementioning

confidence: 99%

Domain Heterogeneity in Radiofrequency Therapies for Pain Relief: A Computational Study with Coupled Models

Singh

Melnik

2020

Bioengineering

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“…Ряд авторов подтверждают, что инъекции МСК снижают уровень болевого синдрома, улучшая качество жизни пациента, и стимулируют восстановление хряща, но в настоящее время нет единого мнения относительно дозировки и частоты инъекций МСК при ОА коленного сустава [31,32,33]. Таким образом, прежде чем инъекции МСК получат широкое распространение, необходимы дополнительные исследования, демонстрирующие безопасность способа забора МСК, дозировок и количества инъекций, а также эффективности в долгосрочной перспективе [34,35,36].…”

Section: результатыunclassified

Management of Chronic Pain Syndrome in Knee Osteoarthritis with Selective Embolization of Popliteal Artery Branches: Review

Козадаев

Щаницын

Гиркало

et al. 2020

Traumatology and Orthopedics of Russia

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Background. Treatment of knee osteoarthritis (OA) in early stages as well as the pain syndrome associated with it usually suggests the combination of medicines and physical therapy means. However, no method has proven its absolute efficiency yet. Transcatheter arterial embolization of popliteal branches is a new minimally invasive treatment that is currently being studied and tested. The objective of our research was the analysis as well as generalization of the outcomes of the pain syndrome in knee OA treatment with the selective embolization of popliteal branches. Materials and Methods. The reviewed articles were retrieved from PubMed database and eLIBRARY digital library considering the criteria like the emboli material, size, and type; possible complications and their effect on the outcome; the patient enrolment criteria for this type of surgical management; the short and long-term outcomes. Results. Transcatheter arterial embolization of popliteal branches is a new minimally invasive method of knee OA treatment. All authors revealed the pathology growth of the vasculature and its complete embolization as a result of the intervention. The review articles present a significant abatement in patients resistant to conventional medical treatment, minimal possible complications, and good long-term outcomes. Conclusion. Since this method of knee OA management is new and understudied, and the number of the published findings does not exceed two hundred it required further thorough investigation and randomized clinical trials.

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“…e most common cause of chronic knee pain is degenerative osteoarthritis most commonly affecting middle-aged and elderly patients resulting in significant functional capacity reduction [1,2]. erapeutic armamentarium includes physical and oral pharmacologic therapy, intraarticular injections, neurolytic or neuromodulatory techniques, transcatheter arterial embolization, minimally invasive arthroscopic treatment, and partial or total knee arthroplasty [3][4][5][6]. Intra-articular application of pulsed radiofrequency with or without viscosupplementation has been reported in different studies as a safe and efficacious technique for pain reduction and mobility improvement in symptomatic patients suffering from degenerative knee osteoarthritis [7][8][9].…”

Section: Introductionmentioning

confidence: 99%

“…Pulsed mode of radiofrequency energy (PRF) deposition is characterized by long silent phases (480 milliseconds) which between the short bursts of energy application (10-20 milliseconds) contribute to maintaining tissue temperature under 42°C which is below the irreversible tissue damage threshold; this results in much less (if any) neurodestructive potential [10,11]. PRF creates a neuromodulatory effect, suppressing both excitatory C-fibers activation and the spread of pain impulse at the synaptic junction, in addition to a modulatory effect on proinflammatory cytokines [6,9]. A variety of pulsed radiofrequency mode utilizes the Poisson curve for energy distribution (Sluijter-Teixera Poisson radiofrequency) (STP) aiming to provide pulses which are meticulously spread in order to achieve highest treatment result with the lowest heat development [12][13][14].…”

Section: Introductionmentioning

confidence: 99%

Intra-Articular Application of Sluijter-Teixera Poisson Pulsed Radiofrequency in Symptomatic Patients with Knee Osteoarthritis: Focus upon Clinical Efficacy and Safety

Filippiadis

Tsochatzis

Petsatodis

et al. 2021

Pain Research and Management

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Purpose. To retrospectively evaluate the effectiveness of intra-articular application of Sluijter-Teixera Poisson pulsed radiofrequency (STP PRF) in knee osteoarthritis symptomatic patients with chronic pain refractory to conservative therapies. Materials and Methods. Institutional database research of two centers identified 39 cases of knee osteoarthritis patients treated with intra-articular STP PRF. Pain prior and one-week and one-, three-, six-, and twelve-month post-STP PRF was compared by means of a numeric visual scale (NVS) questionnaire. Cardiovascular and Interventional Radiological Society of Europe (CIRSE) classification system was used for complications reporting. Mean patient age was 71.59 ± 11.99 years, mean body mass index was 30.23 ± 4.69, and male/female ratio was 9/30. Results. Mean baseline pain score was 8.31 ± 1.70 NVS units. This was reduced to a mean value of 0.90 ± 1.50 NVS units one-week post-RF, 1.08 ± 1.53 at one month, 1.54 ± 1.88 at three months, 2.33 ± 2.17 at six months, and 3.23 ± 2.23 at 12 months of follow-up p < 0.01 . Pain decrease of more than 4 NVS units was noticed in 35/39 knees (89.7%) at first week, 36/39 knees (92.3%) at first month, 35/39 knees (89.7%) at three months, 32/39 knees (82.1%) at six months, and 25/39 knees (64.1%) at one year. There was no recurrence during the follow-up. No complication was observed. Conclusions. Percutaneous, intra-articular application of STP PRF is an effective and safe technique for chronic pain reduction in patients with knee osteoarthritis. Results seem to be reproducible and long lasting with significant patient satisfaction at 12-month follow-up.

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Interventional radiology techniques for pain reduction and mobility improvement in patients with knee osteoarthritis

Cited by 28 publications

References 88 publications

Domain Heterogeneity in Radiofrequency Therapies for Pain Relief: A Computational Study with Coupled Models

Domain Heterogeneity in Radiofrequency Therapies for Pain Relief: A Computational Study with Coupled Models

Management of Chronic Pain Syndrome in Knee Osteoarthritis with Selective Embolization of Popliteal Artery Branches: Review

Intra-Articular Application of Sluijter-Teixera Poisson Pulsed Radiofrequency in Symptomatic Patients with Knee Osteoarthritis: Focus upon Clinical Efficacy and Safety

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