Systematic Review of Radiofrequency Ablation for Management of Knee Pain

Orhurhu, Vwaire; Urits, Ivan; Grandhi, Ravi K.; Abd‐Elsayed, Alaa

doi:10.1007/s11916-019-0792-y

Cited by 20 publications

(24 citation statements)

References 48 publications

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“…Through radiofrequency ablation technology, the posterior medial branch of the spinal nerve can be effectively cut off. Theoretically speaking, this can also completely cut off the path of the pain signal, and thus obtain significant longterm pain relief (14,15). According to previous studies and our experience, the main problem with this technique is incomplete pain-killing in about 10% of these patients.…”

Section: Discussionmentioning

confidence: 95%

Clinical research of percutaneous spinal nerve posteromedial ramus destruction in treatment for chronic facet arthrogenic low back pain: a randomized trial

et al. 2020

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Background: To investigate the clinical effect of percutaneous spinal nerve posteromedial ramus destruction in treatment for chronic facet arthrogenic low back pain.Methods: A total of 118 patients with chronic facet arthrogenic low back pain were enrolled in our hospital from October 2015 to October 2018 and randomly divided into two groups. Of these patients, 59 received conservative treatment as the control group while 59 patients were treated with percutaneous spinal nerve posteromedial ramus destruction as the observation group. Pain score (Visual Analogue Scale, VAS), functional score (Oswestry Disability Index, ODI), treatment score (Japanese Orthopaedic Association, JOA), life quality score (Short Form 36-item Health Survey, SF-36), and lumbar mobility (range of motion, ROM) were evaluated before and after treatment. The treatment effect between two groups was compared. Results:The VAS score and ODI score at 2, 4, and 12 weeks after treatment and last follow-up in the observation group were lower than those of the control group (P<0.05). JOA score, SF-36, and ROM were higher than those of the control group (P<0.05).Conclusions: Percutaneous spinal nerve posteromedial ramus destruction has a significant effect in treatment for chronic facet arthrogenic low back pain, which can relieve pain, improve function, and enhance quality of life.

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Section: Discussionmentioning

confidence: 95%

Clinical research of percutaneous spinal nerve posteromedial ramus destruction in treatment for chronic facet arthrogenic low back pain: a randomized trial

et al. 2020

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“…Radiofrequency ablation has been used for pain management since the mid-1970s [ 46 ] and has significantly evolved from a therapy that was mainly employed for mitigating neuropathic pain to one of the most promising and frequently applied techniques in clinical practices for alleviating axial spine and musculoskeletal pain [ 1 , 16 ]. Today, the application of RFA in treating pain has steadily expanded and accepted for the treatment of facet joint, sacroiliac joint dysfunction and osteoarthritis [ 8 , 9 , 10 , 11 , 12 , 13 , 15 , 16 , 17 , 18 , 19 , 20 ]. However, there are significant contradictions and inconsistencies in the reported clinical results on the efficacy of RF procedures.…”

Section: Clinical Applications Future Outlook and Model Developmementioning

confidence: 99%

“…Several inexpensive alternative treatment options have also been explored in clinical practices for mitigating chronic pain and minimizing the usage of opioids. Among the available treatment modalities for chronic pain relief, minimally invasive radiofrequency ablation offers several advantages, such as it is precise, reproducible, cheap and highly effective [8,9]. The application of radiofrequency (RF) has been growing rapidly and increasing in popularity for treating different types of pain, such as in the management of low back pain, knee pain, hip pain, migraine, etc.…”

Section: Introductionmentioning

confidence: 99%

“…In contrast to the continuous RF mode, which relies on the high temperature to cause neural ablation, the pulsed delivery mode utilizes the application of short pulses of RF current to the neural tissue from the RF generator that is followed by silent phases to allow time for heat dissemination [14,18,19]. The electric field generated due to these applied pulses disrupts the functioning of neuronal membrane, along with genetic changes that affect cytokine release [8]. Thus, the mechanism of action of both these modes is quite different.…”

Section: Introductionmentioning

confidence: 99%

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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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“…Of the American population, 37% have radiographic evidence of osteoarthritic changes of the knee and 12% have knee pain related to arthritis (5). Our group previously performed a systematic review suggesting both short-and long-term improvement in analgesia following RFA of the knee (6). Moreover, RFA has been successfully used for other chronic pain syndromes including radicular pain, sacroiliac joint pain, postsurgical pain, shoulder pain, and myofascial pain (7)(8)(9)(10).…”

mentioning

confidence: 99%

Review of the Safety of Bipolar Radiofrequency Ablation in Patients with Chronic Pain with Implantable Cardiac Rhythm Management Devices

Hanna

Abd‐Elsayed

2021

Pain Phys

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BACKGROUND: Chronic pain, especially low back pain and hip pain, has been a growing public health concern that affects over 100 million Americans annually. Radiofrequency ablation (RFA) has distinct advantages over other chronic pain management modalities and its use has been increasing over the past decade. Among the growing population with comorbid conduction disorders and persistent pain, RFA and its potential interference with implantable cardiac devices is of concern. RFA is becoming a foundational element of persistent pain management and has been shown to be effective in a multitude of chronic pain syndromes. Cardiac implantable electronic devices (CIED), such as cardiac pacemakers or implantable cardioverter defibrillators, have been used in the treatment of cardiac conduction diseases for a number of decades. With our aging population, these diseases have increased in both incidence and prevalence. Chronic pain and cardiac conduction diseases are both common in our increasingly aging population. OBJECTIVES: This study aims to determine if the literature supports the hypothesis that patients with CIEDs can safely use RFA with minimal to no interaction. STUDY DESIGN: Systematic assessment of literature with a modified approach with bipolar RFA. METHODS: A narrative review with systematic assessment of the literature was carried out. In this review, we included randomized controlled trials (RCTs), open non-randomized control studies, prospective studies, retrospective studies, case series, and case reports. All types of radiofrequency utilized for pain management including pulsed and conventional were included. Outcome measures included interactions between the cardiovascular implantable electronic device (CIED) and radiofrequency ablation (RFA), adverse events, RFA efficacy in treating the pain using pain scores, and other complications. RESULTS: Our search criteria yielded 4 studies for inclusion, with inclusion of 33 patients and 71 bipolar radiofrequency for treatments. No adverse events or interactions occurred between the bipolar radiofrequency device and the implanted cardiac devices in any of these patients. Bipolar radiofrequency was utilized in all patients (n = 33). Overall there were no complications or malfunctions. LIMITATIONS: Small sample size, narrative review. CONCLUSIONS: This study provides evidence that bipolar RFA can be safely used in patients with CIEDs for chronic pain provided that proper precautions are employed. Considerations for safe use are provided. KEY WORDS: Chronic pain, CIED, radiofrequency ablation

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Systematic Review of Radiofrequency Ablation for Management of Knee Pain

Cited by 20 publications

References 48 publications

Clinical research of percutaneous spinal nerve posteromedial ramus destruction in treatment for chronic facet arthrogenic low back pain: a randomized trial

Clinical research of percutaneous spinal nerve posteromedial ramus destruction in treatment for chronic facet arthrogenic low back pain: a randomized trial

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

Review of the Safety of Bipolar Radiofrequency Ablation in Patients with Chronic Pain with Implantable Cardiac Rhythm Management Devices

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