Radiofrequency neuroablation as a treatment method for pain syndrome in conservative treatment of knee osteoarthritis
Pain syndrome is one of the most frequent reasons for visiting a doctor of elderly patients with knee osteoarthritis. Pain caused by knee osteoarthritis is nociceptive; therefore, in the treatment of the knee osteoarthritis, it is rational to provide a targeted impact on the structures that produce the pain. Radiofrequency neuroablation (RFNA) allows induce the nociceptive mechanism in the structures conducting pain impulses.
Objective: to evaluate the effectiveness of radiofrequency neuroablation in the treatment of pain syndrome in patients with knee osteoarthritis.
Methods: the open controlled randomized study included treatment results analysis of 44 patients with knee osteoarthritis of the third stage with predominance of pain in one of the knee joints. Patients were divided into two groups: the study group (n = 22) and the comparison group (n = 22). Patients of both groups for the treatment of knee joint pain received osteoarthritis basis therapy. Patients in the study group additionally had RFNA of the genicular nerves. The intensity of the pain syndrome was measured with visual analog scale (VAS) and the functional status and quality of life of patients was analyzed using the WOMAC questionnaire in terms of 2 weeks, 1 and 3 months after the beginning of the treatment.
Results: this study revealed that the functional activity of the patients of both groups was decreased in affected with intensive pain syndrome — the total WOMAC index was 87.0 points in middle range. Positive changes were revealed in both groups of patients. More pronounced and lasting effect of the treatment was obtained in a group of patients undergoing RFNA procedure in combination with basis conservative treatment: decreasing values regard to the VAS to 4.0 points and the total WOMAC index to 33.0 points). In comparison group was admitted the scores reduction of the VAS to 5.5 points and the total WOMAC index to 61.0 points.
Conclusion: RFNA of the genicular nerves, as an additional method of pain treatment, along with conservative therapy in patients with knee osteoarthritis is an effective way of the pain syndrome reducing which improves functional activity and quality of life.
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