Is saphenous nerve radio frequency an effective treatment for advanced gonarthrosis in elders with cardiac comorbidity?

Abstract

PRF is a safe and function sparing minimally invasive pain palliation method for knee osteoarthritis in elders with cardiac comorbidity.

Ultrasound-guided Pulsed Radiofrequency of the Saphenous Nerve for Knee Osteoarthritis Pain: A Pilot Randomized Trial

“…Overall, our analysis favors real PRF over sham to improve pain and function and quality of life. In line with our results, two previous retrospective studies of PRF treatment of the saphenous nerve showed a significant reduction in pain and function scores in 115 OA patients resistant to conventional therapies [18] and in 84 patients with cardiac comorbidities affected by grade 3-4 gonarthritis [23], respectively. Both these studies revealed a 6 months efficacy of PRF on pain and function, but their retrospective design and the lack of a control group limit the generalization of their results.…”

“…Despite promising results of PRF of the saphenous nerve, the previous studies were affected by limitations including underpowered sample, lack of control group, short follow-up duration and poor procedural methodology [18,23]. Here we propose a prospective pilot randomized sham-controlled trial with the aim of evaluating efficacy and safety of ultrasound-guided saphenous nerve PRF in patients with chronic OA knee pain, and its impact on disability and quality of life.…”

Accuracy of fluoroscopic-guided genicular nerve blockade: a need for revisiting anatomical landmarks

“…16 17 Contrary to Tran et al who reported that the IPBSN was mainly cutaneous and only innervated the inferior-medial quadrant of the anterior knee joint capsule in 3/15 (20%) specimens, we and other authors 23 24 found that the IPBSN supplied the inferior medial aspect of the anterior knee capsule and the overlying skin and subcutaneous tissue, in all the specimens. Its importance is reinforced by recent clinical studies where ablative treatment of IPBSN alone resulted in a significant decrease of knee pain in patients with knee OA, [25][26][27] with results comparable with those observed in studies performing classical ablative therapy of three genicular nerve. 4 12 13 22 Hu et al 20 demonstrated that a vertical treatment line originating at 50 mm medial to the apex patellae and connecting to a point just inferior to the level of tibial tuberosity would encompass 80% of the nerve innervating the anteromedial region of the inferior knee.…”

Radiofrecuencia pulsada por guia ecografica para el tratamiento del dolor cronico de rodilla

“…Uno realizado en 115 pacientes durante casi 2 años objetivó una mejoría tanto del EVA como del índice de WOMAC (p = 0,001) en los pacientes con gonartrosis grado 1-3 tras la realización de la RFP del nervio safeno (40 voltios, 480 segundos y 42 °C) sin describirse efectos secundarios o complicaciones (20). Otro estudio más reciente realizado en pacientes con gonartrosis grado 3-4 K&L corroboró también una efectividad significativa y mantenida con la RFP del nervio safeno a los 6 meses (p < 0,001) (29). En nuestra muestra con la RFP del nervio safeno (monopolar, 45 voltios, 42 °C y 240 segundos) en los pacientes con dolor predominante en el área anteromedial de la rodilla, se obtuvo una reducción de -3,82 del EVA, -23,18 del WOMAC total y una mejoría del EuroQol del + 0,442 (p < 0,0001).…”