Pulse-Dose Radiofrequency for Knee Osteoartrithis

Abstract

Knee osteoarthritis (OA) is a leading cause of disability in the elderly. The purpose of this study was to investigate the effectiveness of pulse-dose radiofrequency (PDRF) in patients with chronic pain refractory to conservative therapies. Between January 2011 and November 2012, PDRF was performed on 40 patients. A 20-gauge cannula, 10 cm in length, was introduced in the antero-lateral region of the interested knee, and its tip was placed in the joint space under fluoroscopic guidance. After the spindle was removed, an RF needle with a 10-mm "active tip" was introduced. PDRF was performed with 1,200 pulses at high voltage (45 V) with 20-ms duration followed by a 480-ms silent phase. Mean VAS scores before the procedures was 6.8 ± 0.8. A great decrease of pain intensity was achieved 1 week after PDRF (mean VAS scores 1.8 ± 0.4 [p < 0.05]) with stabilization of painful symptomatology in the following months and excellent results 1 year after treatment (mean VAS scores 2.3 ± 0.6 after 12 months [p < 0.05]). Western Ontario and McMaster Universities Index of Osteoarthritis scores showed improved quality of life in all patients at 6 months (p < 0.05) and at 1 year (p < 0.05) after PDRF. No patients developed complications. This study successfully investigated the effectiveness of PDRF in patients with chronic pain unresponsive to conservative therapies. PDRF seems to be an effective and reliable technique for palliative management of chronic pain in patients with knee OA.