Abd-Elsayed Alaa, Matta Andrew Y, Nitz James N, Henjum Lukas J, Shiferaw Barnabas T, May Raven, Fiala Kenneth J
Madison School of Medicine and Public Health, Anesthesiology, Division of Chronic Pain Medicine, University of Wisconsin, Madison, USA.
Madison School of Medicine and Public Health, University of Wisconsin, Madison, USA.
Adv Ther. 2024 Jul;41(7):2859-2867. doi: 10.1007/s12325-024-02892-z. Epub 2024 May 27.
Chronic pain is one of the leading causes of reduced quality of life in the USA, with knee pain commonly reported. Multiple therapeutic modalities are traditionally utilized for pain management; however, some patients may have pain refractory to these techniques. Cooled radiofrequency ablation (c-RFA) of the geniculate nerve is a growing and promising therapy offering a potentially long-term solution to chronic knee pain.
This study assessed the efficacy, average duration of relief, and potential adverse events using a retrospective chart review of 406 procedures. A two-tailed paired t test was used to assess the statistical significance between pre-RFA vs. post-RFA visual analog scale (VAS) pain scores self-reported by patients. An analysis of variance (ANOVA) test was used to evaluate for statistical differences in pre-RFA pain scores and post-RFA pain scores among the categories of age, sex, body mass index (BMI), and diagnosis group.
The mean percent in pain improvement calculated was 65.5% with an average duration of relief of 7.20 months. The average pre-RFA pain score on the VAS was 6.26 out of 10 and 2.59 out of 10 post-RFA. The ANOVA post-RFA pain scores demonstrated statistically significant differences among the categories of age and sex. A total of 54 adverse events were reported, including worsening pain, numbness, paresthesia, and knee swelling.
The study demonstrated that c-RFA can potentially be utilized as an alternative safe therapy for chronic knee pain, providing pain relief with a relatively prolonged duration. Inherent challenges of retrospective studies remain a part of the limitations of this study.
慢性疼痛是美国生活质量下降的主要原因之一,膝关节疼痛较为常见。传统上,多种治疗方式被用于疼痛管理;然而,一些患者可能对这些技术产生的疼痛难以缓解。膝状神经冷却射频消融术(c-RFA)是一种日益兴起且前景广阔的治疗方法,有望为慢性膝关节疼痛提供潜在的长期解决方案。
本研究通过对406例手术的回顾性病历审查,评估了其疗效、平均缓解持续时间和潜在不良事件。采用双尾配对t检验评估患者自我报告的射频消融术前与术后视觉模拟量表(VAS)疼痛评分之间的统计学差异。使用方差分析(ANOVA)检验评估年龄、性别、体重指数(BMI)和诊断组类别在射频消融术前疼痛评分与术后疼痛评分中的统计学差异。
计算得出的疼痛改善平均百分比为65.5%,平均缓解持续时间为7.20个月。VAS上射频消融术前平均疼痛评分为10分中的6.26分,术后为10分中的2.59分。方差分析显示,术后疼痛评分在年龄和性别类别之间存在统计学显著差异。共报告了54例不良事件,包括疼痛加重、麻木、感觉异常和膝关节肿胀。
该研究表明,c-RFA有可能作为慢性膝关节疼痛的一种安全替代疗法,提供相对较长时间的疼痛缓解。回顾性研究的固有挑战仍然是本研究局限性的一部分。