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膝下外侧象限疼痛的膝神经射频消融术的安全性和有效性。

The safety and efficacy of genicular nerve radiofrequency ablation for pain in inferolateral quadrant of the knee.

作者信息

Shi Weibin, Vu To-Nhu, Annaswamy Thiru, Wu Hong, Moore Bryan, Mears Chad, Kunselman Allen R

机构信息

Department of Physical Medicine and Rehabilitation, Penn State Health Milton S Hershey Medical Center/Penn State College of Medicine, Hershey, PA, USA.

Penn State Hershey Rehabilitation Hospital, Hummelstown, PA, USA.

出版信息

Interv Pain Med. 2023 May 31;2(2):100253. doi: 10.1016/j.inpm.2023.100253. eCollection 2023 Jun.

Abstract

BACKGROUND

Genicular nerve radiofrequency ablation (RFA) is an effective procedure to alleviate knee pain. This procedure has been proven to be safe, except in the inferior lateral quadrant (ILQ) due to its innervation being near the common fibular nerve (CFN). Given the complexity of this approach, pain physicians do not routinely perform RFA in the ILQ, leading to inadequate pain relief in this region.

METHODS

This is a retrospective study of 54 patients who had undergone genicular nerve RFA. Thirty patients had genicular nerve RFA of the knee joint including the ILQ innervated by the inferolateral genicular and recurrent fibular nerves, while 24 patients had RFA of the knee joint without involvement of the ILQ. We compared the outcomes (pain relief, function, and complications) in the patients with and without ILQ RFA at 3 months and 6 months after RFA.

RESULTS

There was no significant difference in initial pain and functional level before RFA between these two groups. After RFA, the two groups had comparable pain relief at 3 months (p ​= ​0.06) and 6 months (p ​= ​0.20), and similar functionality at 3 months (p ​= ​0.29) and 6 months (p ​= ​0.12). There were no reported complications after RFA with or without ILQ RFA.

CONCLUSIONS

RFA of the innervation to the ILQ of the knee is as safe and effective as all other anterior quadrants.

摘要

背景

膝神经射频消融术(RFA)是缓解膝关节疼痛的有效方法。除了膝关节下外侧象限(ILQ),该手术已被证明是安全的,因为其神经支配靠近腓总神经(CFN)。鉴于此手术入路的复杂性,疼痛科医生通常不在ILQ进行RFA,导致该区域疼痛缓解不足。

方法

这是一项对54例行膝神经RFA患者的回顾性研究。30例患者对包括由膝下外侧神经和腓总返神经支配的ILQ在内的膝关节进行了膝神经RFA,而24例患者对未累及ILQ的膝关节进行了RFA。我们比较了RFA后3个月和6个月时进行和未进行ILQ RFA患者的治疗效果(疼痛缓解、功能和并发症)。

结果

两组在RFA前的初始疼痛和功能水平上无显著差异。RFA后,两组在3个月(p = 0.06)和6个月(p = 0.20)时的疼痛缓解情况相当,在3个月(p = 0.29)和6个月(p = 0.12)时的功能相似。无论是否进行ILQ RFA,RFA后均未报告并发症。

结论

对膝关节ILQ进行神经支配的RFA与所有其他前侧象限一样安全有效。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e6a5/11373012/6899435335b7/gr1.jpg

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