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透视引导下热髌股神经射频消融术治疗非手术治疗的晚期膝关节骨关节炎患者的疗效:1年随访结果

Effectiveness of the Thermal Genicular Nerve Radiofrequency Ablation Therapy Under Fluoroscopy in Patients with Non-operative Advanced Stage Knee Osteoarthritis: 1-Year Follow-Up Results.

作者信息

Kaya Oğuz, Şenel Ahmet, Batur Ömer Cihan, Gönder Nevzat, Ergen Emre, Peker Barış

机构信息

Department of Orthopaedics and Traumatology, Elazığ Fethi Sekin City Hospital, Elazığ, 23000 Turkey.

Department of Orthopaedics and Traumatology, İstanbul Training and Research Hospital, Istanbul, 34098 Turkey.

出版信息

Indian J Orthop. 2022 Apr 20;56(6):1033-1039. doi: 10.1007/s43465-022-00642-3. eCollection 2022 Jun.

Abstract

BACKGROUND

In this study, our aim was to present the 1-year results of the effect of thermal genicular nerve radiofrequency ablation (GNRFA) therapy on pain and functional outcomes in patients with advanced knee osteoarthritis.

MATERIALS AND METHODS

After retrospectively examining the hospital records, 49 knees of 35 patients who had undergone thermal RFA of the superior medial, superior lateral, and inferior medial branches of the genicular nerve under fluoroscopic guidance between July 2019 and December 2020 were included in the study. The visual analog scale (VAS) scores of the patients were recorded before RFA, on the day of RFA, and at the first, sixth, and 12th months postoperatively, as well as their Western Ontario and McMaster Universities Arthritis Index (WOMAC) scores before RFA and at the 12th month postoperatively. Complications developed after the procedure and during the follow-up period were screened.

RESULTS

Twenty-five of the patients were females and 10 males, with a mean age of 77.3 ± 7.9 years (range 61-92 years). The mean VAS score was 8.4 ± 0.9 before RFA, and as 1.7 ± 1.0 right after the procedure, 2.4 ± 1.7 at the first month, 3.4 ± 1.8 at the sixth month, and 4.4 ± 1.9 at the 12th month ( < 0.01). In terms of the WOMAC score, the average value was 69.7 ± 6.4 before the treatment and 36.1 ± 11.8 at the final follow-up at the 12th month ( < 0.01). No complications were observed in any patient during the treatment or the follow-up period.

CONCLUSION

Non-surgical thermal GNRFA therapy of knee osteoarthritis provides significant outcomes in terms of pain and functionality, with no significant systemic or local side effects. Therefore, the technique can be considered as an alternative to other methods when treating advanced osteoarthritis.

摘要

背景

在本研究中,我们的目的是呈现热膝关节神经射频消融术(GNRFA)治疗晚期膝关节骨关节炎患者疼痛及功能预后的1年结果。

材料与方法

回顾性查阅医院记录后,本研究纳入了2019年7月至2020年12月期间在透视引导下接受膝关节神经上内侧、上外侧及下内侧分支热射频消融术的35例患者的49个膝关节。记录患者在射频消融术前、射频消融当天、术后第1、6和12个月的视觉模拟量表(VAS)评分,以及术前和术后第12个月的西安大略和麦克马斯特大学骨关节炎指数(WOMAC)评分。筛查术后及随访期间出现的并发症。

结果

患者中25例为女性,10例为男性,平均年龄77.3±7.9岁(范围61 - 92岁)。射频消融术前平均VAS评分为8.4±0.9,术后即刻为1.7±1.0,第1个月为2.4±1.7,第6个月为3.4±1.8,第12个月为4.4±1.9(P<0.01)。就WOMAC评分而言,治疗前平均值为69.7±6.4,第12个月最终随访时为36.1±11.8(P<0.01)。治疗或随访期间未观察到任何患者出现并发症。

结论

膝关节骨关节炎的非手术热GNRFA治疗在疼痛和功能方面取得了显著效果,且无明显的全身或局部副作用。因此,在治疗晚期骨关节炎时,该技术可被视为其他方法的替代方案。

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