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冷冻射频消融术治疗骨关节炎相关性膝关节疼痛:证据、适应证及疗效

Cooled Radio Frequency Ablation for the Treatment of Osteoarthritis-Related Knee Pain: Evidence, Indications, and Outcomes.

作者信息

Oladeji Lasun O, Cook James L

机构信息

Department of Orthopaedic Surgery, University of Missouri, Columbia, Missouri.

Missouri Orthopaedic Institute, University of Missouri, Columbia, Missouri.

出版信息

J Knee Surg. 2019 Jan;32(1):65-71. doi: 10.1055/s-0038-1675418. Epub 2018 Nov 5.

Abstract

Knee osteoarthritis (OA) is a common condition associated with pain and physical impairment in a large segment of the population. The traditional treatment algorithm progresses from conservative modalities to nonsurgical options to surgical intervention. Surgical intervention often provides reliable pain relief but not all patients are surgical candidates and there are some patients who prefer not to have surgery. Cooled radio frequency ablation (C-RFA) is a treatment with the potential to provide pain relief for patients who no longer benefit from noninvasive modalities and who desire an alternative to surgery. The objective of this review article is to provide the rationale, available evidence, indications, and outcomes associated with C-RFA for the treatment of chronic knee OA. A total of eight reports that use C-RFA in the treatment of chronic knee pain were identified and analyzed. There were two prospective trials, one retrospective cohort study, and five case reports or case series. C-RFA is an emerging procedure with encouraging early results; however, additional long-term prospective clinical trials are necessary to further characterize how C-RFA can best be used to treat chronic knee pain.

摘要

膝关节骨关节炎(OA)是一种常见疾病,在很大一部分人群中会引发疼痛和身体功能障碍。传统的治疗方案从保守治疗逐步过渡到非手术治疗,再到手术干预。手术干预通常能有效缓解疼痛,但并非所有患者都适合手术,而且有些患者不愿接受手术。冷循环射频消融术(C-RFA)是一种治疗方法,对于那些不再从无创治疗中获益且希望替代手术的患者,它有可能缓解疼痛。这篇综述文章的目的是提供与C-RFA治疗慢性膝关节OA相关的理论依据、现有证据、适应症和治疗结果。共识别并分析了八篇使用C-RFA治疗慢性膝关节疼痛的报告。其中有两项前瞻性试验、一项回顾性队列研究以及五项病例报告或病例系列。C-RFA是一种新兴的治疗方法,早期结果令人鼓舞;然而,还需要更多长期的前瞻性临床试验,以进一步明确C-RFA如何能最佳地用于治疗慢性膝关节疼痛。

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