Radiofrequency ablation against arthritis
Cooled radiofrequency ablation (CRFA) of the knee joint in osteoarthritis effectively relieves pain and improves the functional state of the joint in comparison with intra-articular administration of steroids.
Osteoarthritis of the knee joint (gonarthritis) is quite common in the elderly, accompanied by pain and hinders movement, significantly impairing the quality of life. The gold standard of treatment is knee replacement. But it is sometimes impossible to perform the operation due to the patient's age or severe concomitant diseases. Usually, in such cases, intra-articular administration of steroid anti-inflammatory drugs that relieve pain is performed. The disadvantages of this method of treatment are invasiveness, short-term effect, side effect of drugs on cartilage tissue.
A group of researchers led by Dr. Leonardo Kapural from the Winston Salem Research Center, North Carolina, studied the CRFA method as an alternative to steroids. The study involved 151 patients suffering from chronic osteoarthritis of the knee joint for more than 10 years. They were randomly assigned to the CRFA treatment group and the intra-articular steroid administration group.
The CRFA method is a non-invasive effect of radiofrequency energy on the nerves of the knee in order to interrupt the transmission of pain impulses to the brain. Before the procedure, patients underwent a medical blockade of the sensory knee nerve in order to make sure that the pain in the joint is associated with this particular nerve. CRFA is performed on an outpatient basis under local anesthesia and with minimal sedation of the patient.
Before and after the compared interventions, patients were asked to assess the intensity of pain on a ten-point scale. Before the study, it averaged 7 points, a month after treatment – 3 in the CRFA group and 4 in the steroid group. After 6 months, 74% of the participants in the CRFA group noted a reduction in pain by at least half a point, while in the steroid group there were 16%. Within 6 months after treatment, knee joint function was assessed as satisfactory by 40% of patients in the CRFA group and 3% of patients in the intra-articular steroid administration group. Improvement of the general condition was noted by 90% and 24%, respectively. Also, patients of the CRFA group used painkillers much less often. No serious complications or undesirable side effects were observed in any of the groups.
Among the disadvantages of the study, the authors note the small number of participants and the lack of blind control: both doctors and patients knew which group they belonged to. The authors intend to conduct a new, longer study to evaluate the effectiveness of the method for a year or more to determine the moment when the ablated nerve regenerates and a repeat procedure will be required.
The results of the study demonstrate the advantages of the method of cooled radiofrequency ablation in osteoarthritis of the knee joint: a clinically significant reduction in pain intensity and a longer effect compared with intra-articular administration of steroids. This means that CRFA can significantly improve the quality of life of elderly patients suffering from osteoarthritis of the knee joint.
Article by Tim Davis et al. Prospective, Multicenter, Randomized, Crossover Clinical Trial Comparing the Safety and Effectiveness of Cooled Radiofrequency Ablation With Corticosteroid Injection in the Management of Knee Pain From Osteoarthritis is published in the journal Regional Anesthesia & Pain Medicine.
Aminat Adzhieva, portal "Eternal Youth" http://vechnayamolodost.ru according to Wolters Kluwer Health: Noninvasive procedure is superior to steroid injection for painful knee osteoarthritis.