MRI-guided neurolysis for the treatment of chronic refractory knee pain: a case report.

Chronic refractory pain poses a significant challenge in knee joint pathologies, especially after exhaustion of conservative, arthroscopic, and endoprosthetic therapy options. This case report illustrates an innovative approach using MRI-assisted chemical neurolysis of a genicular nerve to manage persistent knee pain after arthroscopy. A 62-year-old male patient with chronic refractory knee pain, primarily localized at the inferomedial part of the knee, underwent high-resolution MRI to visualize the genicular nerves. This allowed for targeted ethanol-based neurolysis of the inferomedial genicular nerve. Following the procedure, the patient experienced substantial pain reduction for the follow-up duration of 4 months. The successful use of MRI-assisted chemical neurolysis offers a promising alternative treatment for patients with refractory knee pain, providing long-lasting pain relief without major side effects. This technique has the potential to improve the quality of life for patients suffering from chronic knee pain While these initial results are encouraging, it is important to note that further research, including both short-term and long-term studies, as well as randomized controlled trials, is warranted to establish the efficacy and safety of this treatment method in broader populations before it can be considered for routine incorporation into pain management practices.
Competing Interests: Declarations Ethics approval and consent to participate All procedures were conducted according to the principles expressed in the Declaration of Helsinki. Written informed consent was obtained from all participants prior to inclusion. Conflict of interest Dr. Dimitrios Karampinos reports receiving funding grants from Philips Healthcare. Dr. Kilian Weiss reports financial support and employment with Philips Germany GmbH. All other authors declare no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(© 2024. The Author(s).)