Ultrasound-Guided Genicular Nerve Thermal Radiofrequency Ablation for Chronic Knee Pain
Osteoarthritis (OA) of the knee is one of the most common joint diseases affecting adults in the United States. For elderly patients with multiple medical comorbidities who do not wish to undergo total knee arthroplasty (TKA), lifestyle modification, pharmacologic management, and injections are the...
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| Format: | Article |
| Language: | English |
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Wiley
2016-01-01
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| Series: | Case Reports in Anesthesiology |
| Online Access: | http://dx.doi.org/10.1155/2016/8292450 |
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| author | Joshua Wong Nicholas Bremer Paul D. Weyker Christopher A. J. Webb |
| author_facet | Joshua Wong Nicholas Bremer Paul D. Weyker Christopher A. J. Webb |
| author_sort | Joshua Wong |
| collection | DOAJ |
| description | Osteoarthritis (OA) of the knee is one of the most common joint diseases affecting adults in the United States. For elderly patients with multiple medical comorbidities who do not wish to undergo total knee arthroplasty (TKA), lifestyle modification, pharmacologic management, and injections are the mainstay of therapy. Previously, pain management interventions were limited to intra-articular joint injections and viscosupplementation with hyaluronic acid. Fluoroscopic-guided techniques for radiofrequency ablation (RFA) of the genicular nerves have been previously described and a recent cadaveric study suggests that ultrasound-guided genicular nerve blocks can be performed accurately. We performed an ultrasound-guided radiofrequency ablation of the genicular nerves in 88-year-old woman who had deferred surgical management given her age. Following successful ultrasound guided diagnostic genicular nerve blocks, she proceeded to RFA using the same ultrasound guided technique. The procedure resulted in significant pain relief and improvement in overall function for greater than 6 months. The use of ultrasound provides a relatively rapid and noninvasive method to directly visualize genicular nerves and surrounding vasculature. Our case suggests that, for genicular nerve blockade and RFA, ultrasound may be a useful alternative to fluoroscopy. Not only did the procedure result in significant pain relief that has persisted for greater than 6 months but also more importantly her function status and quality of life were improved. |
| format | Article |
| id | doaj-art-d91a69859c484b40bd55cdc4092589e6 |
| institution | Kabale University |
| issn | 2090-6382 2090-6390 |
| language | English |
| publishDate | 2016-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Anesthesiology |
| spelling | doaj-art-d91a69859c484b40bd55cdc4092589e62025-02-03T06:08:15ZengWileyCase Reports in Anesthesiology2090-63822090-63902016-01-01201610.1155/2016/82924508292450Ultrasound-Guided Genicular Nerve Thermal Radiofrequency Ablation for Chronic Knee PainJoshua Wong0Nicholas Bremer1Paul D. Weyker2Christopher A. J. Webb3Columbia University Medical Center, Department of Anesthesiology, New York, NY, USAColumbia University Medical Center, Department of Anesthesiology, New York, NY, USADivisions of Pain Medicine, Regional Anesthesia & Critical Care Anesthesia, Columbia University Medical Center, Department of Anesthesiology, New York, NY, USADivisions of Pain Medicine, Regional Anesthesia & Liver Transplant Anesthesia, Columbia University Medical Center, Department of Anesthesiology, New York, NY, USAOsteoarthritis (OA) of the knee is one of the most common joint diseases affecting adults in the United States. For elderly patients with multiple medical comorbidities who do not wish to undergo total knee arthroplasty (TKA), lifestyle modification, pharmacologic management, and injections are the mainstay of therapy. Previously, pain management interventions were limited to intra-articular joint injections and viscosupplementation with hyaluronic acid. Fluoroscopic-guided techniques for radiofrequency ablation (RFA) of the genicular nerves have been previously described and a recent cadaveric study suggests that ultrasound-guided genicular nerve blocks can be performed accurately. We performed an ultrasound-guided radiofrequency ablation of the genicular nerves in 88-year-old woman who had deferred surgical management given her age. Following successful ultrasound guided diagnostic genicular nerve blocks, she proceeded to RFA using the same ultrasound guided technique. The procedure resulted in significant pain relief and improvement in overall function for greater than 6 months. The use of ultrasound provides a relatively rapid and noninvasive method to directly visualize genicular nerves and surrounding vasculature. Our case suggests that, for genicular nerve blockade and RFA, ultrasound may be a useful alternative to fluoroscopy. Not only did the procedure result in significant pain relief that has persisted for greater than 6 months but also more importantly her function status and quality of life were improved.http://dx.doi.org/10.1155/2016/8292450 |
| spellingShingle | Joshua Wong Nicholas Bremer Paul D. Weyker Christopher A. J. Webb Ultrasound-Guided Genicular Nerve Thermal Radiofrequency Ablation for Chronic Knee Pain Case Reports in Anesthesiology |
| title | Ultrasound-Guided Genicular Nerve Thermal Radiofrequency Ablation for Chronic Knee Pain |
| title_full | Ultrasound-Guided Genicular Nerve Thermal Radiofrequency Ablation for Chronic Knee Pain |
| title_fullStr | Ultrasound-Guided Genicular Nerve Thermal Radiofrequency Ablation for Chronic Knee Pain |
| title_full_unstemmed | Ultrasound-Guided Genicular Nerve Thermal Radiofrequency Ablation for Chronic Knee Pain |
| title_short | Ultrasound-Guided Genicular Nerve Thermal Radiofrequency Ablation for Chronic Knee Pain |
| title_sort | ultrasound guided genicular nerve thermal radiofrequency ablation for chronic knee pain |
| url | http://dx.doi.org/10.1155/2016/8292450 |
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