Diario de Manejo del Dolor y Medicina

Abstracto

Comparison of Cooled Radiofrequency Ablation and Genicular Nerve Blockade for the Treatment of Osteoarthritic Knee Pain: A Prospective Randomized Double-Blind Study

Samer Khojah, Eyad Mitwali, Osama AlAhdal, Abdullah Kaki

Background: Osteoarthritis is a chronic degenerative disease that can represent a source of significant pain. When conservative therapies fail to relief the pain and surgery is not an option. Other choices like Genicular Nerve Blockade (GNB) using a mixture of local anesthetic agents and steroids or genicular nerve ablation using a Cooled Radio Frequency Ablation (CRFA) will be the option.

Methods: In this prospective randomized double-blind study, 41 patients with chronic osteoarthritic knee pain were randomly assigned to either CRFA (n=21) of genicular nerves or GNB (n=20) at the superomedial, superolateral, and inferomedial aspects of the knee. Pain status and patient function were assessed using numerical pain score and Sfax Western Ontario McMaster Universities Osteoarthritis (WOMAC) index respectively, at 3, 6, 9, and 12 months after the intervention.

Results: The mean age of the patients was 71.2 ± 9.5 (mean ± SD) years, with marked female dominance (73.2%). Severity of pain, WOMAC score, or the used medications were not significantly different between the groups (p>0.05). Reduction in the average pain score and WOMAC index (p<0.05) after the intervention was significantly different within the groups but not between the groups (p>0.05). Pain relief lasted for a significantly longer duration in CRFA patients (6.8 ± 4.61 months) than in GNB patients (2.9 ± 1.17 months) (p<0.05). There were no reported complications.

Conclusions: Both CRFA and GNB were significantly effective in reducing pain and improving the function of knee osteoarthritis; however, CRFA is superior to GNB regarding the duration of pain relief.