Is preoperative genicular radiofrequency ablation effective for reducing pain following total knee arthroplasty? A pilot randomized clinical trial.
Is preoperative genicular radiofrequency ablation effective for reducing pain following total knee arthroplasty? A pilot randomized clinical trial.
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术前膝关节射频消融对减轻全膝关节置换术后疼痛有效吗？一项初步随机临床试验。
DOI：
10.1136/rapm-2021-102501
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发表时间：
2021-09
影响因子：
5.1
通讯作者：
Bruehl, Stephen
中科院分区：
文献类型：
--
作者：
Mishra, Puneet;Edwards, David;Huntoon, Marc;Sobey, Christopher;Polkowski, Gregory;Corey, John;Mishra, Kelly Louise;Shinar, Andrew;Engstrom, Stephen;Palmer, Cassandra;Bruehl, Stephen
虽然全膝关节置换术（TKA）是严重膝骨关节炎（OA）的有效治疗方法，但一部分患者会经历明显的术后疼痛和不满意。一些临床试验支持膝神经射频消融术（GN-RFA）对非手术性膝关节炎的镇痛作用，但只有一项先前的试验检查了术前给予这种干预对TKA术后结果的影响，显示冷却GN-RFA没有镇痛作用。目前的研究评估了术前进行常规热GN-RFA是否能显著改善TKA后的疼痛和功能。这是一项单中心、前瞻性、随机、假对照、双盲的先导试验，患者在TKA前2至4周接受常规GN-RFA （n=30）或假疗法（n=30）。在干预当天术前获得基线测量值，并在手术当天以及术后2周和6周获得随访结果。在6周的随访中，接受GN-RFA治疗的患者在主要结局、休息时疼痛强度方面与对照组相比没有显著改善。次要结果，包括行走疼痛和身体功能，在任何随访评估中也显示两组之间没有显著差异。在TKA前对膝上外侧神经、膝上内侧神经和膝下内侧神经进行常规的GN-RFA，在术后2周或6周时，并没有提供临床意义上的疼痛缓解或功能状态改善。NCT02947321。
Although total knee arthroplasty (TKA) is an effective treatment for severe knee osteoarthritis (OA), a subset of patients experience significant postoperative pain and dissatisfaction. Several clinical trials support the analgesic benefits of genicular nerve radiofrequency ablation (GN-RFA) for non-operative knee OA, but only one prior trial has examined the effects of this intervention given preoperatively on postoperative outcomes following TKA, showing no analgesic benefit of cooled GN-RFA. The current study evaluated whether conventional thermal GN-RFA performed preoperatively resulted in significant improvements in pain and function following TKA. This was a single-center, prospective, randomized, sham-controlled, double-blinded pilot trial in which patients received either conventional GN-RFA (n=30) or sham (n=30) between 2 and 4 weeks prior to their TKA. Baseline measures were obtained preprocedurally on the day of intervention, with follow-up outcomes obtained preoperatively on the day of surgery, and at 2 and 6 weeks postoperatively. Patients receiving GN-RFA showed no significant improvements relative to sham controls in the primary outcome, pain intensity at rest at 6-week follow-up. Secondary outcomes, including pain with ambulation and physical function, also showed no significant differences between groups at any follow-up assessment. Conventional GN-RFA of the superior lateral, superior medial, and inferior medial genicular nerves when performed prior to TKA did not provide clinically significant pain relief or improvement in functional status at 2 or 6 weeks postoperatively. NCT02947321.
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影响因子：
7.4
作者：
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通讯作者：
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影响因子：
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