1. Which one is more effective for the clinical treatment of chronic pain in knee osteoarthritis: radiofrequency neurotomy of the genicular nerves or intra-articular injection?
- Author
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İmran Kurt Ömürlü, Sinem Sarı, Ufuk Efe, Osman Nuri Aydin, Yasemin Turan, and Pınar Özlülerden
- Subjects
Male ,musculoskeletal diseases ,Time Factors ,WOMAC ,Knee Joint ,Turkey ,Visual analogue scale ,Osteoarthritis ,Betamethasone ,Injections, Intra-Articular ,03 medical and health sciences ,0302 clinical medicine ,Rheumatology ,030202 anesthesiology ,medicine ,Humans ,Prospective Studies ,Anesthetics, Local ,Glucocorticoids ,Aged ,Pain Measurement ,Aged, 80 and over ,Bupivacaine ,Analgesics ,Morphine ,business.industry ,Chronic pain ,Pain scale ,Middle Aged ,Osteoarthritis, Knee ,Neurotomy ,medicine.disease ,Arthralgia ,Denervation ,Analgesics, Opioid ,Treatment Outcome ,Anesthesia ,Female ,Chronic Pain ,business ,030217 neurology & neurosurgery ,medicine.drug - Abstract
Objectives To compare the efficacy of intra-articular injection and radiofrequency (RF) neurotomy of genicular nerves in patients with chronic knee osteoarthritis (OA) pain. Methods Seventy-three patients with knee OA were included in the study. Patients were randomly assigned to Group IA (intra-articular 2.5 mL of bupivacaine, 2.5 mg of morphine and 1 mL of betamethasone, 6 mL of fluid injection) or Group RF (RF neurotomy of the genicular nerves). The outcome measures included a pain scale (visual analog scale, VAS) and Western Ontario and McMaster Universities (WOMAC) Index of Osteoarthritis. Results No statistically significant difference was found between the two groups in baseline VAS-pain. In Group RF, a significant reduction was observed in VAS-pain at the first month (P < 0.001) and the third month (P < 0.001) in comparison to Group IA. Also in Group RF, a significant reduction was observed in WOMAC total scores in the first month (P < 0.001) in comparison to Group IA. Conclusion This study is the first controlled study in the literature which compares RF genicular nerve to intra-articular injections. This study demonstrated that genicular nerve RF neurotomy is a safe and efficient treatment modality and provides functional improvement along with an analgesia in patients with chronic knee OA.
- Published
- 2016