The use of radiofrequency neuroablation for pain syndrome in patients with gonarthrosis grade 3 to 4

Abstract

The aim of the study was to evaluate the effectiveness of treatment of gonalgia, pain syndrome associated with knee osteoarthritis, using radiofrequency neuroablation (RFNA) of nerves. Materials and methods The data of 92 patients (92 joints) who underwent outpatient treatment at the State Institution "Institute of Traumatology and Orthopedics of the National Academy Medical Sciences of Ukraine" from 2017 to 2019 were analyzed. The patients' condition was assessed before the RFNA procedure, after 2 weeks, and then 1, 3, 6 and 12 months after the procedure. Results According to the results of the VAS before treatment, it was 9.10 ± 0.04 cm. Thus, one month after RFNA in the group of patients, there was a significant decrease in pain syndrome according to the VAS within 3.96 ± 0.28 cm (p ≤ 0.05). After 3 months a stable positive result was retained in the group at the level of 4.33 ± 0.29 cm; after 6 months – 4.46 ± 0.32 cm; after 12 months – 5.01 ± 0.34 cm (p ≤ 0.05). After RFNA treatment, an improvement in the functional capabilities of the damaged joints was observed according to the WOMAC questionnaire (change by more than 15 points), namely, after 2 weeks the indicator was 52.60 ± 1.60 points, after 1 month – 48.80 ± 2.01 points, after 3 months – 51.29 ± 1.99 points, after 6 months – 54.18 ± 2.32 points, after 1 year – 55.48 ± 2.60 points. Discussion The results of our study complement the results of randomized controlled trials by Choi, Taverner, Alcidi, Takahashi et al which state that RFNA is an effective method of treating pain in patients with gonarthrosis in both short-term (2-4 weeks) and long-term follow-up (more than 3 months). Conclusions Radiofrequency neuroablation of the articular branches of the knee nerves is an effective and safe method for treating pain in gonalgia, but it is not universal and does not prevent the disease.