Kapural Leonardo, Minerali Amela, Sanders Matthew, Matea Matejic, Dua Simran
Carolinas Pain Institute, Winston Salem, NC, USA.
Pain Management Fellowship Program, Department of Anesthesiology, Wake Forest Baptist Medical Center, Winston-Salem, NC, USA.
J Pain Res. 2022 Aug 31;15:2577-2586. doi: 10.2147/JPR.S373877. eCollection 2022.
Genicular radiofrequency ablation is an established therapy for chronic knee pain. An analysis comparing different probe sizes and technologies has not yet been undertaken for this indication. This large retrospective, comparison study from a single-center comprehensive pain management practice aims to do that.
Outcomes of 170 patients who underwent traditional radiofrequency ablation (tRFA) for chronic knee pain were compared to 170 consecutive patients who received cooled radiofrequency ablation (CRFA) with similar (p=0.5) pre-procedural pain scores.
The VAS pain score at the first post-procedure visit at 4-6 weeks decreased to 5.07±2.8 cm for tRFA and to 4.26 ± 3.2 cm for CRFA (p<0.001 for both from baseline). The difference was profound and significantly better in the favor of CRFA (p<0.001) as the duration of reduction of pain scores by greater than 50% was 2.6 months for tRFA and 11.1 months for CRFA. There were only 15 patients (8.8%) who continued to receive >50% of pain relief in tRFA at 12 months, as opposed to 78 (46%) at 12 months for CRFA. We compared the initial outcomes and long-term pain relief. Long-term outcomes were better for the bigger lesion size treatment group patients.
We conclude that the duration and intensity of pain relief were of a greater magnitude after the larger diameter probe cooled RFA.
膝部射频消融术是治疗慢性膝关节疼痛的一种既定疗法。尚未针对该适应症对不同探头尺寸和技术进行比较分析。这项来自单中心综合疼痛管理实践的大型回顾性比较研究旨在做到这一点。
将170例因慢性膝关节疼痛接受传统射频消融术(tRFA)的患者的结果与170例连续接受冷循环射频消融术(CRFA)且术前疼痛评分相似(p = 0.5)的患者进行比较。
在术后4 - 6周的首次随访时,tRFA组的视觉模拟评分(VAS)疼痛评分降至5.07±2.8厘米,CRFA组降至4.26±3.2厘米(两者与基线相比p均<0.001)。差异显著,且明显有利于CRFA组(p<0.001),因为tRFA组疼痛评分降低超过50%的持续时间为2.6个月,CRFA组为11.1个月。tRFA组在12个月时只有15例患者(8.8%)持续获得超过50%的疼痛缓解,而CRFA组在12个月时有78例患者(46%)。我们比较了初始结果和长期疼痛缓解情况。较大病变尺寸治疗组患者的长期结果更好。
我们得出结论,较大直径探头冷循环射频消融术后疼痛缓解的持续时间和强度更大。