Masala Salvatore, Fiori Roberto, Raguso Mario, Calabria Eros, Cuzzolino Alessandro, Fusco Armando, Simonetti Giovanni
Department of Diagnostic and Molecular Imaging, Interventional Radiology and Radiation Therapy, University of Rome "Tor Vergata", Rome, Italy.
Int J Rheum Dis. 2017 Mar;20(3):309-316. doi: 10.1111/1756-185X.12635. Epub 2015 May 20.
To assess the efficiency of pulse-dose radiofrequency (PDRF) in the management of chronic pain in patients with trapezio-metacarpal osteoarthritis (OA).
Seventy-five patients with trapezio-metacarpal OA were treated with the PDRF between October 2011 and September 2013. A 22-gauge cannula with a 5-cm length was introduced with percutaneous access in the lateral region of the affected trapezio-metacarpal joint. The PDRF procedure was performed with 1200 pulses at 45 V and 20 msec duration, followed by a 480 msec silent phase. The follow-up visits were performed at 1 month, 3 and 6 months after the PDRF procedure. All patients underwent a second treatment between 7 and 9 months after the first PDRF procedure with a new follow-up scheme at 1, 3, 6 and 9 months.
Mean visual analogue scale (VAS) scores before the procedures was 8.5 ± 1.1. A great reduction in pain intensity was reported at 3 months after the PDRF procedure (mean VAS scores 3.1 ± 0.9, P < 0.05). Pain intensity began to increase back to pre-procedural values after 4 months (mean VAS scores at 6 months was 7.9 ± 1.3, P < 0.05). After the second PDRF treatment the mean VAS scores decreased to 3.3 ± 0.8 at 3 months, but increased to 8.1 ± 1.6 at 9 months. (P < 0.05). No complications after the procedures were observed.
The PDRF may be a safe, repeatable and effective short-term pain management technique in patients with trapezio-metacarpal OA. Larger, randomized controlled studies are indicated to better clarify the efficacy and utility of the PDRF.
评估脉冲剂量射频（PDRF）治疗第一掌腕关节骨关节炎（OA）患者慢性疼痛的疗效。
2011年10月至2013年9月期间，75例第一掌腕关节OA患者接受了PDRF治疗。采用一根长度为5 cm的22号套管针经皮穿刺进入患侧第一掌腕关节外侧区域。PDRF治疗过程中给予45 V、持续时间20毫秒的1200个脉冲，随后是480毫秒的静息期。在PDRF治疗后1个月、3个月和6个月进行随访。所有患者在首次PDRF治疗后7至9个月接受第二次治疗，并在1个月、3个月、6个月和9个月采用新的随访方案。
治疗前平均视觉模拟量表（VAS）评分为8.5±1.1。PDRF治疗后3个月疼痛强度显著降低（平均VAS评分3.1±0.9，P<0.05）。4个月后疼痛强度开始回升至治疗前水平（6个月时平均VAS评分为7.9±1.3，P<0.05）。第二次PDRF治疗后，3个月时平均VAS评分降至3.3±0.8，但9个月时升至8.1±1.6（P<0.05）。治疗后未观察到并发症。
PDRF可能是治疗第一掌腕关节OA患者安全、可重复且有效的短期疼痛管理技术。需要开展更大规模的随机对照研究以更好地阐明PDRF的疗效和实用性。
