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冷却射频关节突神经消融术治疗膝骨关节炎慢性膝痛的疗效:一项双盲、随机、对照研究。

Effectiveness of the Cooled Radiofrequency Ablation of Genicular Nerves in Patients with Chronic Knee Pain Due to Osteoarthritis: A Double-Blind, Randomized, Controlled Study.

机构信息

Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Republic of Korea.

出版信息

Medicina (Kaunas). 2024 May 24;60(6):857. doi: 10.3390/medicina60060857.

Abstract

: Increasing evidence supporting the clinical effectiveness of cooled radiofrequency ablation (RFA) therapy for genicular nerves in patients with chronic knee osteoarthritis (OA) exists. However, no study has been conducted to eliminate the potential influence of a placebo effect associated with this procedure. Therefore, we evaluated the efficacy of cooled RFA compared with a sham procedure in patients with painful knees due to OA. : In this double-blind, randomized, controlled study, participants were randomly assigned to receive cooled RFA of the knee (cooled RFA group, n = 20) or a sham procedure (sham group, n = 20). The primary outcome was the proportion of successful responders at the three-month follow-up. The secondary outcomes were successful responders at one and six months; pain intensity of the knee; functional status; medication; and satisfaction at one, three, and six months after the procedures. : For the primary outcome, the successful responder rate was significantly higher in the cooled RFA group (76.5%) than in the sham group (33.3%) ( = 0.018). For the secondary outcome, more successful responders were observed in the cooled RFA group than in the sham group at one and six months after the procedure ( = 0.041 and 0.007, respectively). The decreased knee pain intensity was maintained throughout the six-month follow-up period in the cooled RFA group. No differences were observed in functional status, medication change, or satisfaction in both groups. : The cooled RFA of genicular nerves offers significant pain relief and surpasses the effects attributable to a placebo.

摘要

:越来越多的证据支持冷却射频消融(RFA)治疗慢性膝关节骨关节炎(OA)患者膝关节神经的临床疗效。然而,目前尚无研究消除与该手术相关的潜在安慰剂效应的影响。因此,我们评估了冷却 RFA 与膝关节假手术相比在 OA 引起的疼痛膝关节患者中的疗效。:在这项双盲、随机、对照研究中,参与者被随机分配接受膝关节冷却 RFA(冷却 RFA 组,n = 20)或假手术(假手术组,n = 20)。主要结局是三个月随访时成功应答者的比例。次要结局是一个月和六个月时的成功应答者;膝关节疼痛强度;功能状态;药物治疗;以及手术后一个、三个月和六个月的满意度。:对于主要结局,冷却 RFA 组(76.5%)的成功应答率明显高于假手术组(33.3%)(= 0.018)。对于次要结局,冷却 RFA 组在手术后一个月和六个月时的成功应答者多于假手术组(= 0.041 和 0.007)。在冷却 RFA 组,膝关节疼痛强度在整个六个月的随访期间均持续下降。两组在功能状态、药物变化或满意度方面均无差异。:冷却的关节内神经 RFA 可提供显著的疼痛缓解,并超过安慰剂的效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f68d/11206112/b2bff888385a/medicina-60-00857-g001.jpg

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