Pulsed radiofrequency ablation of genicular nerve versus intra-articular radiofrequency ablation combined with platelets rich plasma for chronic kneeosteoarthritis

Abstract

ABSTRACTBackground knee osteoarthritis is considered as one of the most important causes of knee pain. Conventional noninvasive lines of treatment are several, including platelet-rich plasma (PRP) that has been revealed to be helpful in the management of knee osteoarthritis. The goal of this study is to appraise the PRP ultrasound-guided injection in the management of knee osteoarthritis.Settings and Design This study was a prospective randomised double blind study.Methods Sixty adult knee osteoarthritis patients were involved in the current study. They were randomly selected from the pain clinic Faculty of Medicine, Alexandria University. There were two groups ultrasound-guided (USG) pulsed waves radiofrequency (PRF) ablation on genicular nerve (group 1) or intra-articular PRP (group 2) injection under ultrasonography (US)-guidance and articular surface RF ablation. Assessment was done applying visual analogue scale (VAS) for pain intensity. Functionally, WOMAC and IKDC scores were used at baseline and 6th month after injection.Results Intra-articular PRP (group 2) showed a significant improvement in pain severity and physical limitations in patients with knee pain. It also showed significant improvement compared to genicular nerve RF considering VAS score with p value (0.012*) up to 12 months follow up, WOMAC, IKDC scores with p value (<0.001*) up to 12 months and US joint assessment with p value (0.028*) up to 6 months follow up.Conclusion The use of US IA-PRP injection combined to pulsed radiofrequency ablation of articular surface show significant improvement in pain compared to the genicular nerve PRF.

Keywords

• Chronic knee pain
• genicular nerves pulsed radiofrequency ablation
• platelets rich plasma