Radiofrequency Ablation for the Treatment of Painful Neuroma

Connors, James C.; Boike, Allan; Rao, Nilin M; Kingsley, J. Derek

doi:10.1053/j.jfas.2019.09.003

Cited by 10 publications

(8 citation statements)

References 32 publications

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“… 9 The pulse generator of RFA creates an electromagnetic field surrounding the electrode tip that activates adjacent molecules, thus generating frictional heat. 10 It is currently used to improve joint function and relieve pain by destroying nerves that innervate painful tissue or by disturbing the transmission of pain signals. RFA is reportedly a reliable method for the management of chronic knee pain related to knee OA.…”

Section: Introductionmentioning

confidence: 99%

Efficacy and safety of radiofrequency ablation for treatment of knee osteoarthritis: a meta-analysis of randomized controlled trials

Zhang

Wang

et al. 2021

J Int Med Res

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Objective To evaluate the efficacy and safety of radiofrequency ablation for the treatment of knee osteoarthritis. Methods A literature review was conducted using the PubMed, Cochrane Review, Embase, and Google Scholar databases. Two reviewers independently assessed the eligibility of all retrieved studies. The research was reported based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to ensure the reliability and verity of the results. The statistical analysis was performed using STATA version 13.0. Results Nine randomized controlled trials were collected for the data extraction and meta-analysis. Significant differences in the pain score at 4, 12, and 24 weeks were found between patients treated with radiofrequency ablation and those treated with placebo. Furthermore, the use of radiofrequency ablation was associated with an improved outcome of the Western Ontario and McMaster Universities Arthritis Index at 4, 12, and 24 weeks. No serious adverse events were observed in any patients who underwent radiofrequency ablation. Conclusion Radiofrequency ablation is efficacious and safe for reducing pain and improving knee function in patients with knee osteoarthritis, without increasing the risk of adverse effects.

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Section: Introductionmentioning

confidence: 99%

Efficacy and safety of radiofrequency ablation for treatment of knee osteoarthritis: a meta-analysis of randomized controlled trials

Zhang

Wang

et al. 2021

J Int Med Res

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“…Connors et al (39) reported functional improvement of 97.5 out of 100 post RFA. However, pre-procedure scores were not available, so the degree of change is difficult to compare to the present study.…”

Section: Discussionmentioning

confidence: 97%

Efficacy of radiofrequency ablation versus ethanol ablation for Morton's neuroma: a clinical trial using patient recorded outcome measures

Silvester

Nargahi²,

Woods

et al. 2022

Preprint

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Background Morton’s neuroma is a common cause of forefoot pain and can be difficult to treat. Ethanol ablation (ETA) and Radiofrequency ablation (RFA) are increasingly used for treatment of chronic Morton's neuroma. However, there is limited evidence on the effectiveness of these guided ablation therapies in relation to broad-ranging patient recorded outcome measures (PROMs), and prospective studies directly comparing the two interventions are lacking. In this pragmatic clinical trial, we aimed to compare the efficacy of Ethanol ablation (ETA) and Radiofrequency ablation (RFA) on patient recorded outcome measures (PROMs) in pain, function, and ability in patients with Morton's neuroma. Methods Participants with chronic Morton's neuroma were randomly assigned to either ETA or RFA. Outcome measures were the Visual Analogue Scale (VAS), the eight-domain Foot Health Status Questionnaire (FHSQ) and the Foot and Ankle Ability Measure (FAAM). These were assessed at baseline, three, and six months after treatment. Results Sixty-three participants were allocated to either RFA (n=35) or ETA (n=28). A slight decrease in pain ascertained through VAS scores was observed in both intervention groups over six months relative to baseline. FAAM scores moderately improved in both groups over six months, with ETA showing a marginally greater mean change compared to RFA (3.8 points; p=0.004). FHSQ scores improved from baseline to six months in both groups, across all domains except vigour, which decreased in both interventions over three months and then stabilised in the ETA group at six months. Between-group differences of minor clinical importance favouring the ETA group were reported in improvement from baseline to six months of foot pain (3.7 points on 100 point scale; p<0.005), foot function (3.3 points; p=0.017), general health (2.5 points; p=0.013), and physical activity (11.0 points; p<0.001). Conclusion In the treatment of chronic Morton’s neuroma, ETA and RFA appear to confer comparable six-month improvements in pain, foot health, function, and ability. Multi-dimensional scales such as the FHSQ and the FAAM potentially elicit substantial treatment-related improvements that are not evident from VAS. Accordingly, incorporation of diverse PROMs into clinical assessments may enhance therapeutic decision-making and research in this context. Trial registration Australian New Zealand Trials Registry (ANZCTR) ACTRN12622000912785 (retrospectively registered on 27/06/2022

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“… Malignant tumors (skeletal metastases, myeloma, soft tissue metastases, and plasmocytomas) also combined with cementoplasty [ 13 , 35 , 36 , 37 ]. Neurovascular diseases related to the musculoskeletal system: Use for palliative pain relief; targeting locoregional neural supply, neuromas, neuroendocrine metastases, hemangioendotheliomas, and intramuscular hemangioma [ 38 , 39 ]. …”

Section: Interventional Radiology—techniquesmentioning

confidence: 99%

“…Neurovascular diseases related to the musculoskeletal system: Use for palliative pain relief; targeting locoregional neural supply, neuromas, neuroendocrine metastases, hemangioendotheliomas, and intramuscular hemangioma [ 38 , 39 ].…”

Section: Interventional Radiology—techniquesmentioning

confidence: 99%

Interventional Radiology in the Management of Metastases and Bone Tumors

Sgalambro

Zugaro

Bruno

et al. 2022

JCM

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Interventional Radiology (IR) has experienced an exponential growth in recent years. Technological advances of the last decades have made it possible to use new treatments on a larger scale, with good results in terms of safety and effectiveness. In musculoskeletal field, painful bone metastases are the most common target of IR palliative treatments; however, in selected cases of bone metastases, IR may play a curative role, also in combination with other techniques (surgery, radiation and oncology therapies, etc.). Primary malignant bone tumors are extremely rare compared with secondary bone lesions: osteosarcoma, Ewing sarcoma, and chondrosarcoma are the most common; however, the role of interventional radiology in this fiels is marginal. In this review, the main techniques used in interventional radiology were examined, and advantages and limitations illustrated. Techniques of ablation (Radiofrequency, Microwaves, Cryoablation as also magnetic resonance imaging-guided high-intensity focused ultrasound), embolization, and Cementoplasty will be described. The techniques of ablation work by destruction of pathological tissue by thermal energy (by an increase of temperature up to 90 °C with the exception of the Cryoablation that works by freezing the tissue up to −40 °C). Embolization creates an ischemic necrosis by the occlusion of the arterial vessels that feed the tumor. Finally, cementoplasty has the aim of strengthening bone segment weakened by the growth of pathological tissue through the injection of cement. The results of the treatments performed so far were also assessed and presented focused the attention on the management of bone metastasis.

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Radiofrequency Ablation for the Treatment of Painful Neuroma

Cited by 10 publications

References 32 publications

Efficacy and safety of radiofrequency ablation for treatment of knee osteoarthritis: a meta-analysis of randomized controlled trials

Efficacy and safety of radiofrequency ablation for treatment of knee osteoarthritis: a meta-analysis of randomized controlled trials

Efficacy of radiofrequency ablation versus ethanol ablation for Morton's neuroma: a clinical trial using patient recorded outcome measures

Interventional Radiology in the Management of Metastases and Bone Tumors

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