Open AccessConventional Thermal versus Water-Cooled Genicular Nerve Radiofrequency Lesioning: A Retrospective Chart Review
Author(s) -
Cristina Shea
Publication year - 2019
Publication title -
interventional pain management reports
Language(s) - English
Resource type - Journals
ISSN - 2575-9841
DOI - 10.36076/pmcr.2019/3/167
Subject(s) - medicine , visual analogue scale , confidence interval , pulsed radiofrequency , retrospective cohort study , surgery , anesthesia , knee pain , osteoarthritis , pain relief , alternative medicine , pathology
Background: Genicular nerve radiofrequencylesioning (RFL) is an interventional approach tochronic knee pain. It is currently unknown whetherconventional thermal RFL (CT-RFL) or watercooledRFL (WC-RFL) yields better outcomes.Objective: The objective of this research wasto analyze and compare outcomes of genicularnerve conventional thermal radiofrequency lesioning(CT-RFL) vs water-cooled radiofrequencylesioning (WC-RFL) for the treatment of chronicknee pain.Study Design: We used retrospective chartreview.Setting: The research took place in an outpatientpain clinic at a large academic medical center.Methods: Patients who participated in the studywere those aged 18 and older who received genicularnerve RFL for chronic knee pain betweenJanuary 1, 2014 and December 31, 2016. Randomintercepts models were used to examine VisualAnalog Scale (VAS) pain scores across the firstyear of follow-up, adjusting for age, gender, andprior history of knee surgery.Results: Overall, VAS scores were significantlyreduced from baseline (mean = 6.66, standarddeviation [SD] = 1.36) by 1.46 points during thefirst follow-up month (95% confidence interval [CI],0.6-2.3, P = .001), 2.22 points during the secondfollow-up month (95% CI, 1.4-3.1, P = < .001), and1.24 points during the sixth follow-up month (95%CI, 0.1-2.4, P = .035) but were not significantlyreduced at other months during the one-year followuptime period. There was no statistically significantdifference in follow-up pain scores (mean difference= 0.73, 95% CI, -0.14-1.59, P = .116) or rates ofcomplications (P = .10, 2-tailed Fisher exact test)between RFL types.Limitations: Study shortcomings include patientloss to follow-up, heterogeneity of CT-RFL techniques,and heterogeneity of study patients.Conclusions: Genicular RFL is a promising strategyfor long-term management of treatment-resistantchronic knee pain. In this study, no significant differencein outcomes was detected between CT-RFLand WC-RFL techniques. Larger prospective studiesare warranted to compare outcomes of thesetechniques and guide future care.Key words: Radiofrequency lesioning, knee pain,chronic pain, osteoarthritis, genicular, cooled radiofrequencylesioning, water-cooled radiofrequencylesioning, conventional radiofrequency lesioning