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Petrera MR, Aparisi Gómez MP, Guglielmi R, Guglielmi G, Bazzocchi A. Interventional Radiology for Rheumatic Diseases. Radiol Clin North Am 2024; 62:913-927. [PMID: 39059981 DOI: 10.1016/j.rcl.2024.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/28/2024]
Abstract
Imaging plays a key role in the management of rheumatological pathologies, also as guidance for diagnostic and therapeutic interventional procedures, as it can provide better accuracy and safety compared to palpation-guided interventions. Inflammatory and degenerative conditions nonresponsive to systemic treatment may benefit from intra-articular and periarticular administration of drugs, with therapeutic and symptomatic actions or providing a bridge for surgery. Desired effects include reduction of inflammation and pain and improvement of physical function of patients. Training and knowledge of indications, appropriate procedures, contraindications, and side effects are necessary to obtain maximum accuracy and safety in performing interventional procedures.
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Affiliation(s)
- Miriana Rosaria Petrera
- Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Rizzoli, Via G. C. Pupilli 1, Bologna 40136, Italy
| | - Maria Pilar Aparisi Gómez
- Department of Radiology, Auckland City Hospital, 2 Park Road, Grafton, Auckland 1023, New Zealand; Department of Anatomy and Medical Imaging, Waipapa Taumata Rau | University of Auckland, Building 501-002, 85 Park Road, Grafton, New Zealand; Department of Radiology, IMSKE, Calle Suiza, 11, València 46024, Spain
| | - Riccardo Guglielmi
- Department of Radiology and Nuclear Medicine, Luzerner Kantonsspital, Lucerne, Switzerland
| | - Giuseppe Guglielmi
- Department of Clinical and Experimental Medicine, Foggia University School of Medicine, Foggia, Italy; Radiology Unit, "Dimiccoli" Hospital, Barletta, Italy; Department of Radiology, Hospital IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Foggia, Italy
| | - Alberto Bazzocchi
- Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Rizzoli, Via G. C. Pupilli 1, Bologna 40136, Italy.
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Deniz R, Güzelbey T, Mutlu İN, Erdim Ç, Akkuzu G, Karaalioğlu B, Özgür DS, Yıldırım F, Kılıçkesmez Ö, Bes C. Successful treatment of a rheumatoid arthritis patient with severe synovial hypertrophy and impaired shoulder function with microwave ablation technique. Skeletal Radiol 2024; 53:1639-1643. [PMID: 38225401 DOI: 10.1007/s00256-024-04580-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 01/04/2024] [Accepted: 01/05/2024] [Indexed: 01/17/2024]
Abstract
Rheumatoid arthritis (RA) is a chronic, inflammatory systemic disorder of synovial joints and results in polyarthritis, chronical degeneration, and finally deformities and ankylosis in severe cases. Synovitis and pannus formation are results of inflammatory changes and lead into restriction in joint movement. Shoulders are among the later affected and larger joints and formation of synovitis in early active stages and pannus in later stages might be concluded with frozen shoulder and severe impairment in functionality. These late-term changes cannot be controlled with systemic or local anti-inflammatory agents and synovectomy is chosen in some cases. However, the results are not satisfactory and recurrence is common. In this case report, we presented a case of RA with severe shoulder pain, restricted movement due to synovial hypertrophy, and pannus formation which are resistant to local and systemic interventions and not suitable for surgical or chemical synovectomy. Microwave ablation (MWA) was performed successfully without any complication and she well responded in terms of DAS-28, functional, and pain scores. Range of motion and funcitonal restriction were recovered. This case report describes the use and promising results of MWA in RA with severe synovial hypertrophy and pannus formation even in the absence of active arthritis and effusion. MWA is a safe and minimally invasive technique that can be easily performed in coordinance of rheumatologists and interventional radiologists in proper cases.
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Affiliation(s)
- Rabia Deniz
- Department of Rheumatology, University of Health Sciences Başakşehir Çam and Sakura City Hospital, Istanbul, Turkey.
- School of Medicine, Faculty of Health Science, Department of Medical Biology and Genetics, Marmara University, Istanbul, Turkey.
| | - Tevfik Güzelbey
- Department of Radiology, University of Health Sciences Başakşehir Çam and Sakura City Hospital, Istanbul, Turkey
| | - İlhan Nahit Mutlu
- Department of Radiology, University of Health Sciences Başakşehir Çam and Sakura City Hospital, Istanbul, Turkey
| | - Çağrı Erdim
- Department of Radiology, University of Health Sciences Başakşehir Çam and Sakura City Hospital, Istanbul, Turkey
| | - Gamze Akkuzu
- Department of Rheumatology, University of Health Sciences Başakşehir Çam and Sakura City Hospital, Istanbul, Turkey
| | - Bilgin Karaalioğlu
- Department of Rheumatology, University of Health Sciences Başakşehir Çam and Sakura City Hospital, Istanbul, Turkey
| | - Duygu Sevinç Özgür
- Department of Rheumatology, University of Health Sciences Başakşehir Çam and Sakura City Hospital, Istanbul, Turkey
| | - Fatih Yıldırım
- Department of Rheumatology, University of Health Sciences Başakşehir Çam and Sakura City Hospital, Istanbul, Turkey
| | - Özgür Kılıçkesmez
- Department of Radiology, University of Health Sciences Başakşehir Çam and Sakura City Hospital, Istanbul, Turkey
| | - Cemal Bes
- Department of Rheumatology, University of Health Sciences Başakşehir Çam and Sakura City Hospital, Istanbul, Turkey
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Park S, Park S, Jang JN, Choi YS, Kim DS, Sohn JE, Park JH. Radiofrequency ablation versus intra-articular mesenchymal stem cell injection for knee osteoarthritis: a systematic review and network meta-analysis. Reg Anesth Pain Med 2024:rapm-2024-105526. [PMID: 38876799 DOI: 10.1136/rapm-2024-105526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2024] [Accepted: 05/28/2024] [Indexed: 06/16/2024]
Abstract
BACKGROUND Knee osteoarthritis (OA) is a prevalent degenerative disease and causes disability, pain and imposes a substantial burden on patients. Conventional treatments for knee OA show limited effectiveness. Consequently, innovative treatments, such as radiofrequency ablation (RFA) and intra-articular mesenchymal stem cells (IA MSC), have gained attention for addressing these limitations. OBJECTIVE We compared the efficacy of RFA and IA MSC for knee OA through a network meta-analysis (NMA). EVIDENCE REVIEW A literature search was conducted using PubMed, MEDLINE, Embase, Cochrane Library, Web of Science and handsearching. Randomized controlled trials (RCTs) comparing RFA or IA MSC to conventional treatments for knee OA were included. The primary outcomes comprised the pain score and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). The clinical outcomes were compared using a frequentist approach, and the treatments were ranked using the surface under the cumulative ranking curve (SUCRA) values. FINDINGS We included 34 RCTs (n=2371). Our NMA revealed that RFA and IA MSC were significantly more effective than conventional treatments in managing pain at both 3 and 6 months with moderate certainty. Specifically, RFA demonstrated the highest SUCRA values, indicating its superior efficacy. For WOMAC scores, both RFA and MSC showed significant improvements at 3 months, with RFA maintaining its lead at 6 months, although MSC did not display significant superiority at this stage. CONCLUSIONS This analysis suggests that RFA and MSC are resilient treatment options in knee OA. Despite some study heterogeneity, these treatments consistently outperformed conventional treatments, particularly in the short to mid-term, although with varying levels of certainty in their efficacy. PROSPERO REGISTRATION NUMBER CRD42023492299.
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Affiliation(s)
- Sukhee Park
- Catholic Kwandong University College of Medicine, Gangneung, Republic of Korea
| | - Soyoon Park
- Catholic Kwandong University College of Medicine, Gangneung, Gangwon-do, Republic of Korea
| | - Jae Ni Jang
- Catholic Kwandong University College of Medicine, Gangneung, Gangwon-do, Republic of Korea
| | - Young-Soon Choi
- Catholic Kwandong University College of Medicine, Gangneung, Gangwon-do, Republic of Korea
| | | | | | - Ji-Hoon Park
- Department of Anesthesiology and Pain Medicine, Keimyung University College of Medicine, Daegu, Republic of Korea
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Misseri G, Gregoretti C, Lo Bianco G. Review of Evaluation and Treatment of Knee Pain. JAMA 2024; 331:706-707. [PMID: 38411652 DOI: 10.1001/jama.2023.27754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/28/2024]
Affiliation(s)
- Giovanni Misseri
- Anesthesiology and Pain Department, Fondazione Istituto G. Giglio Cefalù, Palermo, Italy
| | - Cesare Gregoretti
- Anesthesiology and Pain Department, Fondazione Istituto G. Giglio Cefalù, Palermo, Italy
| | - Giuliano Lo Bianco
- Anesthesiology and Pain Department, Fondazione Istituto G. Giglio Cefalù, Palermo, Italy
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Karm MH, Kwon HJ, Kim CS, Kim DH, Shin JW, Choi SS. Cooled radiofrequency ablation of genicular nerves for knee osteoarthritis. Korean J Pain 2024; 37:13-25. [PMID: 38155108 PMCID: PMC10764214 DOI: 10.3344/kjp.23344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 12/16/2023] [Accepted: 12/18/2023] [Indexed: 12/30/2023] Open
Abstract
Knee osteoarthritis (OA) is a prevalent and debilitating musculoskeletal condition that significantly affects the quality of life of millions of individuals worldwide. In recent years, cooled radiofrequency ablation (CRFA) has become a viable treatment option for knee OA. This review thoroughly evaluated the existing literature on CRFA therapy for knee OA. It delved into the mechanisms behind CRFA, evaluated its clinical efficacy, and investigated potential avenues for future research and application. The insights gained from this review are crucial for healthcare professionals, researchers, and policymakers, offering an updated perspective on CRFA's role as a viable therapeutic option for knee OA.
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Affiliation(s)
- Myong-Hwan Karm
- Department of Dental Anesthesiology, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Korea
| | - Hyun-Jung Kwon
- Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Chan-Sik Kim
- Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Doo-Hwan Kim
- Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jin-Woo Shin
- Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Seong-Soo Choi
- Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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Han J, Ma Q, An Y, Wu F, Zhao Y, Wu G, Wang J. The current status of stimuli-responsive nanotechnologies on orthopedic titanium implant surfaces. J Nanobiotechnology 2023; 21:277. [PMID: 37596638 PMCID: PMC10439657 DOI: 10.1186/s12951-023-02017-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 07/21/2023] [Indexed: 08/20/2023] Open
Abstract
With the continuous innovation and breakthrough of nanomedical technology, stimuli-responsive nanotechnology has been gradually applied to the surface modification of titanium implants to achieve brilliant antibacterial activity and promoted osteogenesis. Regarding to the different physiological and pathological microenvironment around implants before and after surgery, these surface nanomodifications are designed to respond to different stimuli and environmental changes in a timely, efficient, and specific way/manner. Here, we focus on the materials related to stimuli-responsive nanotechnology on titanium implant surface modification, including metals and their compounds, polymer materials and other materials. In addition, the mechanism of different response types is introduced according to different activation stimuli, including magnetic, electrical, photic, radio frequency and ultrasonic stimuli, pH and enzymatic stimuli (the internal stimuli). Meanwhile, the associated functions, potential applications and developing prospect were discussion.
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Affiliation(s)
- Jingyuan Han
- Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases, Shaanxi Engineering Research Center for Dental Materials and Advanced Manufacture, Department of Oral Implants, School of Stomatology, The Fourth Military Medical University, Xi’an, 710032 China
- School of Stomatology, Heilongjiang Key Lab of Oral Biomedicine Materials and Clinical Application, Experimental Center for Stomatology Engineering, Jiamusi University, Jiamusi, 154007 China
| | - Qianli Ma
- Department of Biomaterials, Institute of Clinical Dentistry, University of Oslo, Geitmyrsveien, Oslo, 710455 Norway
| | - Yanxin An
- Department of General Surgery, The First Affiliated Hospital of Xi’an Medical University, Xi’an, China
| | - Fan Wu
- Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases, Shaanxi Engineering Research Center for Dental Materials and Advanced Manufacture, Department of Oral Implants, School of Stomatology, The Fourth Military Medical University, Xi’an, 710032 China
- School of Stomatology, Heilongjiang Key Lab of Oral Biomedicine Materials and Clinical Application, Experimental Center for Stomatology Engineering, Jiamusi University, Jiamusi, 154007 China
| | - Yuqing Zhao
- Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases, Shaanxi Engineering Research Center for Dental Materials and Advanced Manufacture, Department of Oral Implants, School of Stomatology, The Fourth Military Medical University, Xi’an, 710032 China
- School of Stomatology, Heilongjiang Key Lab of Oral Biomedicine Materials and Clinical Application, Experimental Center for Stomatology Engineering, Jiamusi University, Jiamusi, 154007 China
| | - Gaoyi Wu
- School of Stomatology, Heilongjiang Key Lab of Oral Biomedicine Materials and Clinical Application, Experimental Center for Stomatology Engineering, Jiamusi University, Jiamusi, 154007 China
| | - Jing Wang
- Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases, Shaanxi Engineering Research Center for Dental Materials and Advanced Manufacture, Department of Oral Implants, School of Stomatology, The Fourth Military Medical University, Xi’an, 710032 China
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Kolakkanni C, Gonnade NM, Gaur R, Nayyar AK, Ghuleliya R, Tk A. Can ultrasound-guided radiofrequency ablation of genicular nerves of the knee, be performed without locating corresponding arterial pulsations-a cadaveric study. BMC Musculoskelet Disord 2023; 24:654. [PMID: 37587439 PMCID: PMC10429091 DOI: 10.1186/s12891-023-06761-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Accepted: 07/28/2023] [Indexed: 08/18/2023] Open
Abstract
INTRODUCTION Given the rising prevalence of knee osteoarthritis, radiofrequency ablation of genicular nerves (RFA) has emerged as a promising treatment option for knee pain. The knee has an extremely complex and variable innervation with nearly 13 genicular nerves described. The frequently ablated genicular nerves are the superomedial (SMGN), the superolateral (SLGN), and the inferomedial (IMGN) genicular nerves. Conventionally, under ultrasound guidance, these nerves are ablated near the corresponding arterial pulsations, but due to the rich vascular anastomosis around the knee joint, identifying the arteries corresponding to these constant genicular nerves can be tedious unless guided by some bony landmarks. In this study, we have evaluated whether it is possible to accurately target these three genicular nerves by just locating bony landmarks under ultrasound in human cadaveric knee specimens. METHODS Fifteen formalin-fixed cadaveric knee specimens were studied. SMGN was targeted 1 cm anterior to the adductor tubercle in the axial view. For SLGN, in the coronal view, the junction of the lateral femoral condyle and shaft was identified, and at the same level in the axial view, the crest between the lateral and posterior femoral cortex was targeted. For IMGN in the coronal view, the midpoint between the most prominent part of the medial tibial condyle and the insertion of the deep fibers of the medial collateral ligament was marked. The medial end of the medial tibial cortex was then targeted at the same level in the axial view. The needle was inserted from anterior to posterior, with an in-plane approach for all nerves. Eosin, 2% W/V, in 0.1 ml was injected. Microdissection was done while keeping the needle in situ. Staining of the nerve was considered a positive outcome, and the percentage was calculated. The nerve-to-needle distance was measured, and the mean with an interquartile range was calculated. RESULT The accuracies of ultrasound-guided bony landmarks of SMGN, SLGN, and IMGN were 100% in terms of staining, with average nerve-to-needle distances of 1.67, 3.2, and 1.8 mm respectively. CONCLUSION It is with 100% accuracy, that we can perform RFA of SMGN, SLGN, and IMGN under ultrasound guidance, by locating the aforementioned bony landmarks.
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Affiliation(s)
- Chinchu Kolakkanni
- Department of Physical Medicine and Rehabilitation, All India Institute of Medical Sciences, Phase 2 Basni, Jodhpur, Rajasthan, India, 342005
| | - Nitesh Manohar Gonnade
- Department of Physical Medicine and Rehabilitation, All India Institute of Medical Sciences, Phase 2 Basni, Jodhpur, Rajasthan, India, 342005.
| | - Ravi Gaur
- Department of Physical Medicine and Rehabilitation, All India Institute of Medical Sciences, Phase 2 Basni, Jodhpur, Rajasthan, India, 342005
| | - Ashish Kumar Nayyar
- Department of Anatomy, All India Institute of Medical Sciences, Phase 2 Basni, Jodhpur, Rajasthan, India
| | - Rambeer Ghuleliya
- Department of Physical Medicine and Rehabilitation, All India Institute of Medical Sciences, Phase 2 Basni, Jodhpur, Rajasthan, India, 342005
- Department of Physical Medicine and Rehabilitation, Himalayan Institute of Medical Sciences, Swami Ram Nagar, Doiwala, Jolly Grant, Dehradun, Uttarakhand, India, 248140
| | - Abins Tk
- Department of Physical Medicine and Rehabilitation, All India Institute of Medical Sciences, Phase 2 Basni, Jodhpur, Rajasthan, India, 342005
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Chalidis B, Papadopoulos P, Givissis P, Pitsilos C. Is Radiofrequency Ablation Superior to Intra-Articular Injections for the Treatment of Symptomatic Knee Osteoarthritis?-A Systematic Review. J Pers Med 2023; 13:1227. [PMID: 37623477 PMCID: PMC10455107 DOI: 10.3390/jpm13081227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 07/26/2023] [Accepted: 08/01/2023] [Indexed: 08/26/2023] Open
Abstract
The radiofrequency ablation (RFA) is considered a valid, minimally invasive treatment modality for the management of symptomatic knee osteoarthritis (OA). The aim of this study was to compare the outcomes of RFA with that of commonly used intra-articular injections for the persistent knee pain due to OA. Medline/Pubmed and Scopus databases were systematically searched up to April 2023 to identify studies comparing the effect of RFA and intra-articular injections (IAIs) on knee OA. Nine studies including 899 patients fulfilled the eligibility criteria and were included in the systematic review. The RFA procedure was related with improved knee pain relief compared to IAIs at 3-, 6- and 12-month follow-up (p < 0.001). Similarly, functional improvement was greater in RFA treatment than that observed after hyaluronic acid (HA), steroid or platelet-rich plasma (PRP) injections (Visual Analogue Scale p < 0.001, Numeric Rating Scale p = 0.019, Western Ontario and McMaster University Osteoarthritis Index p = 0.012). The overall procedural complication rate of RFA was 10.2% and was higher than steroid (p = 0.023) and PRP (p = 0.017) injections. However, no severe adverse events were reported. For patients with symptomatic knee OA, RFA seems to be more effective than IAIs in alleviating pain and improving joint function, despite the relatively higher incidence of non-serious adverse events. However, due to the limited number of studies and patients, this result should be interpreted with caution and not be generalized to the entire knee OA population.
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Affiliation(s)
- Byron Chalidis
- 1st Orthopaedic Department, Aristotle University of Thessaloniki, 57010 Thessaloniki, Greece;
| | - Pericles Papadopoulos
- 2nd Orthopaedic Department, Aristotle University of Thessaloniki, 54635 Thessaloniki, Greece; (P.P.); (C.P.)
| | - Panagiotis Givissis
- 1st Orthopaedic Department, Aristotle University of Thessaloniki, 57010 Thessaloniki, Greece;
| | - Charalampos Pitsilos
- 2nd Orthopaedic Department, Aristotle University of Thessaloniki, 54635 Thessaloniki, Greece; (P.P.); (C.P.)
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Crema MD, Guermazi A, Roemer FW. Joint interventions in osteoarthritis. Skeletal Radiol 2023; 52:923-931. [PMID: 35982273 DOI: 10.1007/s00256-022-04150-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Revised: 08/04/2022] [Accepted: 08/04/2022] [Indexed: 02/02/2023]
Abstract
Osteoarthritis (OA) is among the most common diseases affecting both axial and appendicular joints and the lead cause of disability worldwide. OA incidence is rising due to extended life expectancy and the increasing obesity epidemic. Several joint interventions are available to manage pain and joint function in patients with OA, most of these treatments being widely applied using intra-articular injections. In this chapter, we will describe the different joint interventions available for the management of pain in OA focusing on intra-articular injections, including discussion on the evidence regarding the efficacy of these treatments, based on the most recent systematic reviews and meta-analyses available. We also discuss the importance of imaging in guiding these treatments, including the different imaging modalities available for intra-articular injection guidance, their advantages, and disadvantages. Finally, we briefly discuss safety data and the consensus regarding the most used intra-articular treatments to manage pain in OA.
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Affiliation(s)
- Michel D Crema
- Institute of Sports Imaging, Sports Medicine Department, French National Institute of Sports (INSEP), 11 avenue du Tremblay, 75012, Paris, France.
- Quantitative Imaging Center, Boston University School of Medicine, Boston, MA, USA.
| | - Ali Guermazi
- Quantitative Imaging Center, Boston University School of Medicine, Boston, MA, USA
- VA Boston Healthcare System, West Roxbury, MA, USA
| | - Frank W Roemer
- Quantitative Imaging Center, Boston University School of Medicine, Boston, MA, USA
- Department of Radiology, Universitätsklinikum Erlangen and Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
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Lipnick S. Editorial Commentary: Radiofrequency Ablation for Patients With Osteoarthritis of the Knee Could Be Indicated for Patients Failing Conventional Nonoperative Treatment and Wishing to Avoid Total Knee Arthroplasty. Arthroscopy 2022; 38:2303-2306. [PMID: 35809982 DOI: 10.1016/j.arthro.2022.03.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Accepted: 03/28/2022] [Indexed: 02/02/2023]
Abstract
Patients with knee osteoarthritis are constantly looking for ways to combat their pain and improve their quality of life. As newer treatments present themselves, it is up to the orthopaedic specialists to provide the best treatment possible. Radiofrequency ablation, usually administered by a pain management specialist, has shown to be an acceptable alternative treatment and should be considered in the management of osteoarthritis. It should be considered for patients who have failed nonoperative treatments and are not interested in pursuing total knee arthroplasty, and possibly for patients who have persistent pain after total knee arthroplasty.
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