Department of Anesthesiology, Intensive Care Medicine, Emergency Medicine and Pain Therapy, Hospital Oost-Limburg, Genk, Belgium.
Faculty of Medicine and Life Sciences, Hasselt University, Diepenbeek, Belgium.
Pain Pract. 2022 Mar;22(3):340-348. doi: 10.1111/papr.13088. Epub 2021 Nov 9.
Radiofrequency (RF) treatment of the genicular nerves is a promising treatment for chronic osteoarthritic and persistent postsurgical knee pain (PPSP), refractory to conventional medical management.
The RECORGEN study is a retrospective single-center cohort study of patients treated with ultrasound-guided conventional RF of the genicular nerves for chronic knee pain in Hospital Oost-Limburg, Genk from September 2017 to June 2020. Subgroup analysis based on etiology of pain (PPSP and degenerative knee pain) was performed in addition to the total study population analysis. Outcome parameters were global perceived effect (GPE), Numeric Rating Scale for pain, consumption of strong opioids, and safety of the treatment at 6 weeks and cross-sectionally at a variable time point. Treatment success was defined as GPE≥50%.
Sixty-eight cases were screened of which 59 (46 diagnosed with PPSP and 13 with degenerative knee pain) were included in the study. Treatment success at 6 weeks was achieved in 19 of 59 interventions (32.2%) and was similar in both groups. Seventeen responders were evaluated at follow-up. 45.1% (8/17) continued to have a positive effect at the second time point. The mean duration of effect of the RF treatment was 8.3 months. Safety analysis at 6 weeks and at the second time point showed a good safety profile of the treatment.
Conventional RF of the genicular nerves was clinically successful in more than 30% of the study population refractory to conventional medical management. Overall, the treatment was well tolerated. The mean duration of effect was 8.3 months.
射频(RF)治疗关节神经是一种有前途的治疗方法,可用于治疗慢性骨关节炎和手术后持续性膝关节疼痛(PPSP),这些疼痛对常规药物治疗无效。
RECORGEN 研究是一项回顾性单中心队列研究,纳入了 2017 年 9 月至 2020 年 6 月在东弗兰德省根克的奥斯特林堡医院接受超声引导下常规 RF 治疗慢性膝关节疼痛的患者。除了对总研究人群进行分析外,还进行了基于疼痛病因(PPSP 和退行性膝痛)的亚组分析。主要观察指标为总体感知效果(GPE)、疼痛数字评分量表、强阿片类药物的使用情况以及治疗的安全性,在 6 周和变时点进行横断面评估。治疗成功定义为 GPE≥50%。
共筛选出 68 例患者,其中 59 例(46 例诊断为 PPSP,13 例诊断为退行性膝痛)纳入研究。59 例干预中,19 例(32.2%)在 6 周时治疗成功,两组间无显著差异。17 例应答者在随访中进行了评估。第二次评估时,8 例(45.1%)继续有积极效果。RF 治疗的平均有效持续时间为 8.3 个月。6 周和第二次评估的安全性分析显示,该治疗具有良好的安全性。
对于常规药物治疗无效的患者,常规 RF 治疗关节神经在研究人群中超过 30%有临床疗效。总体而言,该治疗耐受性良好,有效持续时间平均为 8.3 个月。