Yalcin Cigdem, Salman Mehmet Alper
Mersin City Training and Research Hospital, Department of Algology, Mersin, Türkiye.
Lösante Hospital, Department of Algology, Ankara, Türkiye.
Pain Physician. 2025 Dec;28(S7):S179-S189.
Information on the use of intraarticular bipolar pulsed radiofrequency (IA-bPRF) for treating knee osteoarthritis (KOA) is currently limited, and the effectiveness of this technique is not well established. The most effective nonsurgical approach for alleviating pain caused by KOA is still not well-defined.
Our aim was to investigate the effects of genicular radiofrequency (G-RFT) and IA-bPRF on pain relief and functional improvement in patients with advanced KOA.
Records of 86 patients with KOA who received either G-RFT or IA-bPRF were evaluated retrospectively.
The pain clinic of a state hospital.
KOA patients who received either G-RFT or IA-bPRF were included in the study. The files of patients who were given such interventions between September 2021 and February 2024 were analyzed. Walking pain was evaluated on the numeric rating scale (NRS). Functional assessments were performed using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and the Lequesne Algofunctional Index for Knee (LAI-knee). These evaluations were carried out before the intervention, as well as 2 weeks and 6 months after it.
The IA-bPRF group showed significant improvement in NRS scores when pre-intervention scores were compared to those recorded at the sixth month after the surgery, dropping from 8.62 ± 1.01 to 3.81 ± 1.18, while the scores of the G-RFT group improved from 8.90 ± 1.20 to 5.25 ± 3.40. At the sixth month, WOMAC scores decreased from 75.79 ± 16.00 to 34.21 ± 23.12 in the IA-bPRF group and from 79.02 ± 14.73 to 48.43 ± 30.87 in the G-RFT group. From the pre-intervention period to the sixth month after the procedure, LAI-knee scores went from 18.64 ± 4.16 to 9.90 ± 5.78 in the IA-bPRF group and from 18.89 ± 3.84 to 12.55 ± 7.33 in the G-RFT group. All decreases were significant (P < 0.05). However, WOMAC physical function scores decreased more in the IA-bPRF group than in the G-RFT group (P < 0.05). No serious adverse events occurred.
Our study is subject to several limitations. Primarily, there is a paucity of extensive literature regarding the application of IA-bPRF for KOA. Additionally, our study's sample size is relatively small. This study was conducted at a single center and was retrospective in nature, rather than prospective and randomized, making it challenging to fully control for nuisance variables. Finally, there is a scarcity of comparable studies. These factors may constrain the external validity of our findings.
Pain incurred while walking on flat surfaces and up and down stairs was further reduced with IA-bPRF. IA-bPRF is as effective as G-RFT and even more effective than the latter in some subheadings. Furthermore, the former is a safe alternative for relieving pain in and improving daily life for individuals with advanced KOA. With further research, IA-bPRF may be included in future guidelines for managing chronic KOA pain.
目前关于关节内双极脉冲射频（IA-bPRF）治疗膝骨关节炎（KOA）的应用信息有限，该技术的有效性尚未明确确立。缓解KOA所致疼痛最有效的非手术方法仍未明确界定。
我们的目的是研究膝部射频治疗（G-RFT）和IA-bPRF对晚期KOA患者疼痛缓解和功能改善的影响。
回顾性评估了86例接受G-RFT或IA-bPRF治疗的KOA患者的记录。
一家国立医院的疼痛诊所。
纳入接受G-RFT或IA-bPRF治疗的KOA患者。分析了2021年9月至2024年2月期间接受此类干预的患者档案。采用数字评分量表（NRS）评估行走疼痛。使用西安大略和麦克马斯特大学骨关节炎指数（WOMAC）以及膝关节Lequesne功能疼痛指数（LAI-膝关节）进行功能评估。这些评估在干预前、干预后2周和6个月进行。
与术前评分相比，IA-bPRF组术后6个月的NRS评分显著改善，从8.62±1.01降至3.81±1.18，而G-RFT组评分从8.90±1.20改善至5.25±3.40。在第6个月时，IA-bPRF组的WOMAC评分从75.79±16.00降至34.21±23.12，G-RFT组从79.02±14.73降至48.43±30.87。从干预前期到术后6个月，IA-bPRF组的LAI-膝关节评分从18.64±4.16降至9.90±5.78，G-RFT组从18.89±3.84降至12.55±7.33。所有下降均具有统计学意义（P<0.05）。然而，IA-bPRF组的WOMAC身体功能评分下降幅度大于G-RFT组（P<0.05）。未发生严重不良事件。
我们的研究存在若干局限性。首先，关于IA-bPRF用于KOA的应用，缺乏大量文献。此外，我们研究的样本量相对较小。本研究在单一中心进行，且为回顾性研究，而非前瞻性和随机研究，难以完全控制干扰变量。最后，缺乏可比研究。这些因素可能限制我们研究结果的外部有效性。
IA-bPRF进一步减轻了在平坦表面行走以及上下楼梯时的疼痛。IA-bPRF与G-RFT效果相当，在某些方面甚至比后者更有效。此外，前者是缓解晚期KOA患者疼痛和改善其日常生活的安全选择。随着进一步研究，IA-bPRF可能会被纳入未来慢性KOA疼痛管理指南。
