PRESENTATION #10 Clinical Research | Pain Medicine
THE RETROSPECTIVE OUTCOME ANALYSIS OF COOLED RADIOFREQUENCY ABLATION OF THE GENICULAR NERVES FOR TREATMENT OF CHRONIC KNEE PAIN
Yashar Eshraghi, MD, Ochsner Clinic; Roshina Khan, MD, Ochsner Clinic; Omar Said, MD, Premier Pain and Spine; Maged Guirguis, MD, Ochsner Clinic
Presenter: Darby Larson, BS
Ochsner Health System
Cooled radiofrequency ablation (CRFA) is a technique to treat chronic knee pain conditions such as osteoarthritis (OA) a prevalent problem in aging populations. Studies have demonstrated that using non-cooled radiofrequency ablation (RFA) provides patients significant pain relief. The degree of relief from RFA may be less than in those who received CRFA. Further investigation is warranted to evaluate the effectiveness of CRFA in the chronic knee pain population.
We conducted a retrospective chart review to follow outcomes of CRFA over time. Patient improvement was assessed by comparing pain disability index (PDI) scores, a reliable indication of pain-related disability, as a primary outcome before and after CRFA. The secondary outcomes will be pain scores, measured by Numerical Pain Rating Scale (NPRS), and opioid consumption, represented by Morphine Equivalent Dose (MED).
The charts of 205 patients who had undergone genicular nerve CRFA were reviewed. 104 patients, aged 21-89 years, who had PDI scores prior to the CRFA procedure and at subsequent follow-up clinic visits, had their PDI, NRPS and MED values collected pre-CRFA and post-CRFA. Of the 104 patients, 38 were male and 66 female. The mean PDI score before the CRFA procedure was 38.7; the mean PDI after the CRFA was 26.5. After the CRFA treatment, 67.38% of patients had a decrease, 27.9% had no change, and 4.81% had an increase in their PDI score. The mean NPRS pre-CRFA was 6.98 and was 4.18 post-CRFA with 49.5% of patients experiencing a reduction of 2.25 points, 17.3% a reduction of 0.75 points, and 12.5% a reduction of 3.75 points. The MED for 80.77% of patients did not change, 13.46% had a decrease, and 5.77% had an increase as a result of the procedure. These results indicate patients have a significant reduction in reported pain and pain-related disability following genicular nerve CRFA.