Intraarticular Pulsed Radiofrequency vs. Radiofrequency Neurotomy in Patients with Chronic Knee Pain due to Osteoarthritis (OA)

Background: Advanced age usually suffer from painful osteoarthritis of knee (OA). Treatment of OA pain by nonsteroidal anti-inflammatory is of restricted benefit and surgery is challenging in many patients due to associated medical problems. In this study we used either intraarticular PRF or radiofrequency neurotomy to control pain in patients with chronic knee pain. Aim: The primary outcome of the study was the pain score 10 cm Visual Analog Scale (VAS). The secondary outcome of the study was (1) WOMAC scores (2) Amount of analgesic medications. Methods: This study was conducted on 100 adult patients more than 60 years with chronic knee pain (grade 3 or grade 4) osteoarthritis. Patients were divided into two groups each group contain 50 patients. In group I (intraarticular PRF), patients were treated with PRF where patient was placed in a supine position on the fluoroscopy table, knee joint was flexed to 15°, No genicular block tests were performed. Group 2 (radiofrequency neurotomy), patients were treated with radiofrequency neurotomy. Where patients were placed in a supine position on the fluoroscopy table, knee joint was flexed to 15° and genicular block tests were performed. Results: Our results showed that both groups were comparable regarding age, sex, weight and height. A significantly improvement of pain was noticed in group II when compared to group I at 1 week, 1 month, 3 months and 6 months, 9 months and 12 months (3.2 ± 1.9, 1.8 ± 0.4, 1.9 ± 0.5, 2.1 ± 0.8, 2.2 ± 0.5, 2.9 ± 0.6) p<0.001. In Group 1, there was a significant decrease in mean of VAS scores in comparison to the pre-study values at 1 week, 1 month, 3 months and 6 months (5.6 ± 0.8, 3.8 ± 1.7, 3.9 ± 1.9, 4.2 ± 1.6). While in Group 2 the significant decrease present at 1 week, 1 month, 3 months and 6 months, 9 months and 12 months compared with pretreatment values was (3.2 ± 1.9, 1.8 ± 0.4, 1.9 ± 0.5, 2.1 ± 0.8, 2.2 ± 0.5, 2.9 ± 0.6). Conclusion: Both, the radiofrequency neurotomy or pulsed radiofrequency controls pain in patients with chronic knee pain, decreases amount of analgesic medications consumption, minimize post-operative complications with the upper hand to radiofrequency neurotomy.