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Genicular nerve radiofrequency ablation practice patterns: A survey study of the International Pain and Spine Interventional Society.

作者信息

Ehsanian Reza, Fernandez Shawn, Cooper Amanda, Cushman Daniel M, Conger Aaron, Burnham Taylor, Fogarty Alexandra E, Aiyer Rohit, Smolinski Katie, McCormick Zachary L

机构信息

Division of Pain Medicine, Department of Anesthesiology and Critical Care Medicine, University of New Mexico School of Medicine, Albuquerque, NM, USA.

University of New Mexico School of Medicine, Albuquerque, NM, USA.

出版信息

Interv Pain Med. 2024 Aug 19;3(3):100432. doi: 10.1016/j.inpm.2024.100432. eCollection 2024 Sep.


DOI:10.1016/j.inpm.2024.100432
PMID:39502912
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11536318/
Abstract

INTRODUCTION: Chronic knee pain often results from degenerative conditions such as knee osteoarthritis (OA) and can worsen after surgical interventions like total knee arthroplasty (TKA). Knee OA affects approximately 86 million individuals globally, leading to decreased function, mobility limitations, and disability. While TKA is a common surgical treatment for refractory knee OA, though up to 20 % of patients experience chronic post-operative knee pain worse than their pre-operative pain. Genicular nerve radiofrequency ablation (GnRFA) has emerged as a promising intervention for knee OA pain unresponsive to conservative management and for chronic post-TKA pain. GnRFA is an evidence-based technique supported by multiple prospective cohort studies and randomized controlled trials (RCTs). However, practice patterns and GnRFA techniques vary, and no peer-reviewed publication has yet quantified these variations in real-world clinical practice. OBJECTIVE: This study aims to understand the practice patterns of interventional pain physicians regarding patient selection, use of prognostic blocks, imaging, nerve targets, GnRFA types, and GnRFA techniques in treating knee pain secondary to OA or persistent post-TKA pain. METHODS: An anonymous 29-question survey was distributed via electronic mail to members of the International Pain and Spine Intervention Society (IPSIS) from January 16, 2024, to February 29, 2024. The survey assessed practice patterns related to patient selection, prognostic block use, and GnRFA techniques. Data were collected and stored using REDCap software, with descriptive statistics calculated. RESULTS: A total of 150 completed surveys were analyzed, representing a completion rate of 2.0 % of surveys sent, 3.5 % of emails opened, and 56.8 % of those who clicked on the survey link. Respondents generally use common selection protocols regarding OA grade (Kelgren-Lawrence 3 and 4), duration of failed conservative care (3-6 months), a single anesthetic block paradigm, and use of fluoroscopic guidance for the GnRFA procedure. More variability was reported between respondents regarding the volume of anesthetic used during prognostic blocks, the threshold to consider a prognostic block "positive," the technology used, and nerves targeted during the GnRFA procedure. CONCLUSION: The study provides valuable insights into the current practice patterns of GnRFA among interventional pain physicians. While there is consensus on some aspects of patient selection and procedural techniques, significant variability exists in prognostic block protocols and nerve targets for GnRFA. These findings highlight the need for further research to explore the long-term efficacy and safety of GnRFA and to standardize techniques and protocols across different practice settings, ultimately improving patient outcomes and quality of life. The low response rate may limit generalizability, and the survey did not include data on active tip sizes used for ablation or whether other procedures should be exhausted before resorting to GnRFA. Additionally, a survey to IPSIS membership only may not fully represent a diverse cohort of pain management specialists, potentially introducing sampling bias. Future studies should include members from a broader range of professional organizations to enhance representativeness.

摘要
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9f03/11536318/d719cda18609/gr1a.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9f03/11536318/d719cda18609/gr1a.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9f03/11536318/d719cda18609/gr1a.jpg

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Genicular nerve radiofrequency ablation practice patterns: A survey study of the International Pain and Spine Interventional Society.

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[2]
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引用本文的文献

[1]
Physician compensation rates and gender disparities in interventional spine and pain practices: Insights from a Spine Intervention society survey study.

Interv Pain Med. 2025-4-16

[2]
Evaluating the effectiveness of genicular radiofrequency ablation for chronic knee pain using the patient-reported outcomes measurement information system (PROMIS) global health-physical health domain: Results of a cross-sectional cohort study.

Interv Pain Med. 2025-1-9

本文引用的文献

[1]
The therapeutic effect of genicular nerve radiofrequency for chronic knee pain after a total knee arthroplasty: A systematic review.

Interv Pain Med. 2022-2-17

[2]
On the validity and clinical utility of comparative local anesthetic blocks for the diagnosis of spine pain.

Interv Pain Med. 2023-6-2

[3]
Complications and opioid-prescribing patterns following genicular nerve radiofrequency ablation versus intra-articular injection: a matched cohort study.

Reg Anesth Pain Med. 2025-1-7

[4]
Bipolar radiofrequency ablation of genicular nerves in chronic knee pain: A novel technique for more complete sensory denervation.

J Back Musculoskelet Rehabil. 2024

[5]
Genicular nerve radiofrequency ablation for the treatment of chronic knee joint pain: a real-world cohort study with evaluation of prognostic factors.

Pain Med. 2023-12-1

[6]
Core Recommendations for Osteoarthritis Care: A Systematic Review of Clinical Practice Guidelines.

Arthritis Care Res (Hoboken). 2023-9

[7]
A Survey on the Choice of Spinal Cord Stimulation Parameters and Implantable Pulse Generators and on Reasons for Explantation.

Orthop Rev (Pavia). 2022-11-12

[8]
Recommendations for the delivery of therapeutic exercise for people with knee and/or hip osteoarthritis. An international consensus study from the OARSI Rehabilitation Discussion Group.

Osteoarthritis Cartilage. 2023-3

[9]
Dural Puncture During Spinal Cord Stimulator Lead Insertion: Analysis of Practice Patterns.

Anesth Pain Med. 2022-5-11

[10]
Telemedicine Implementation in Pain Medicine: A Survey Evaluation of Pain Medicine Practices in Spring 2020.

Pain Physician. 2022-8

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