Cooled Radiofrequency Ablation of the Genicular Nerves for Chronic Pain due to Knee Osteoarthritis: Six-Month Outcomes

Abstract Objective. Determine outcomes of cooled radiofrequency ablation (C-RFA) of the genicular nerves for treatment of chronic knee pain due to osteoarthritis (OA). Design. Cross-sectional survey. Setting. Academic pain medicine center. Subjects. Consecutive patients with knee OA and 50% or great...

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Bibliographic Details
Published in:Pain medicine (Malden, Mass.) Mass.), 2017-09, Vol.18 (9), p.1631-1641
Main Authors: McCormick, Zachary L., Korn, Marc, Reddy, Rajiv, Marcolina, Austin, Dayanim, David, Mattie, Ryan, Cushman, Daniel, Bhave, Meghan, McCarthy, Robert J., Khan, Dost, Nagpal, Geeta, Walega, David R.
Format: Article
Language:English
Subjects:
Ablation
Aged
Arthritis
Arthroplasty (knee)
Chronic pain
Chronic Pain - etiology
Chronic Pain - surgery
Cross-Sectional Studies
Denervation - methods
Female
Humans
Joint surgery
Knee
Male
Middle Aged
Nerves
Osteoarthritis
Osteoarthritis, Knee - complications
Pain
Pain Management - methods
Patients
Radiofrequency ablation
Retrospective Studies
Success
Surveys and Questionnaires
Treatment Outcome
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Summary:Abstract Objective. Determine outcomes of cooled radiofrequency ablation (C-RFA) of the genicular nerves for treatment of chronic knee pain due to osteoarthritis (OA). Design. Cross-sectional survey. Setting. Academic pain medicine center. Subjects. Consecutive patients with knee OA and 50% or greater pain relief following genicular nerve blocks who underwent genicular nerve C-RFA. Methods. Survey administration six or more months after C-RFA. Pain numeric rating scale (NRS), Medication Quantification Scale III (MQSIII), Patient Global Impression of Change (PGIC), and total knee arthroplasty (TKA) data were collected. Logistic regression was used to identify factors that predicted treatment success. Results. Thirty-three patients (52 discrete knees) met inclusion criteria. Thirty-five percent (95% confidence interval [CI] = 22–48) of procedures resulted in the combined outcome of 50% or greater reduction in NRS score, reduction of 3.4 or more points in MQSIII score, and PGIC score consistent with “very much improved/improved.” Nineteen percent (95% CI = 10–33) of procedures resulted in complete pain relief. Greater duration of pain and greater than 80% pain relief from diagnostic blocks were identified as predictors of treatment success. The accuracy of the model was 0.88 (95% CI = 0.78–0.97, P 
ISSN:1526-2375
1526-4637
DOI:10.1093/pm/pnx069