Rojhani Solomon, Qureshi Zan, Chhatre Akhil
From Department of Physical Medicine & Rehabilitation, The Johns Hopkins School of Medicine, Baltimore, Maryland (SR, AC).
Am J Phys Med Rehabil. 2017 Jan;96(1):e5-e8. doi: 10.1097/PHM.0000000000000549.
Chronic osteoarthritis (OA) is a widespread source of pain and disability and represents a growing economic burden across aging populations. Representing a major focus of arthritis care, OA of the knee is especially concerning as it has the potential to restrict mobility and significantly impair quality of life. Chronic OA is often poorly managed both pharmacologically and nonpharmacologically, with surgical management representing the definitive treatment. Those who are not surgical candidates or simply opt for minimally invasive treatments are usually faced with a lack of alternatives. An additional treatment presents itself in the form of water-cooled radiofrequency ablation, which involves the use of thermal lesions to interrupt the active pain pathways. An 81-year-old woman with bilateral severe knee OA was initially seen and evaluated in an outpatient physiatry clinic after multiple previous workups of her ongoing knee pain. With a known diagnosis of end-stage knee OA, the patient chose to proceed with bilateral water-cooled radiofrequency ablation. At 6 weeks and 3 months after the procedure, the patient maintained adequate levels of pain relief, markedly improved function, and enhanced quality of life. Water-cooled radiofrequency ablation has the potential to create lasting pain relief and with minimal adverse effects in patients with chronic knee OA.
慢性骨关节炎（OA）是疼痛和残疾的广泛来源，在老龄化人群中造成日益沉重的经济负担。膝关节OA作为关节炎护理的主要重点，尤其令人担忧，因为它有可能限制活动能力并严重损害生活质量。慢性OA在药物和非药物治疗方面往往管理不善，手术治疗是最终治疗手段。那些不适合手术或仅选择微创治疗的患者通常面临缺乏其他选择的困境。一种额外的治疗方法是水冷射频消融，它利用热损伤来中断活跃的疼痛通路。一名81岁双侧重度膝关节OA女性患者，此前因持续膝关节疼痛多次接受检查，最初在门诊物理医学与康复诊所就诊并接受评估。已知诊断为终末期膝关节OA，患者选择进行双侧水冷射频消融。术后6周和3个月时，患者疼痛缓解程度良好，功能显著改善，生活质量提高。水冷射频消融有可能为慢性膝关节OA患者带来持久的疼痛缓解，且副作用最小。
