The Korean Journal of Pain

The Korean Pain Society (대한통증학회)
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Cooled radiofrequency ablation of genicular nerves for knee osteoarthritis

  • Myong-Hwan Karm (Department of Dental Anesthesiology, School of Dentistry and Dental Research Institute, Seoul National University) ;
  • Hyun-Jung Kwon (Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Chan-Sik Kim (Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Doo-Hwan Kim (Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Jin-Woo Shin (Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Seong-Soo Choi (Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine)
  • Received : 2023.12.07
  • Accepted : 2023.12.18
  • Published : 2024.01.01
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Abstract

Knee osteoarthritis (OA) is a prevalent and debilitating musculoskeletal condition that significantly affects the quality of life of millions of individuals worldwide. In recent years, cooled radiofrequency ablation (CRFA) has become a viable treatment option for knee OA. This review thoroughly evaluated the existing literature on CRFA therapy for knee OA. It delved into the mechanisms behind CRFA, evaluated its clinical efficacy, and investigated potential avenues for future research and application. The insights gained from this review are crucial for healthcare professionals, researchers, and policymakers, offering an updated perspective on CRFA's role as a viable therapeutic option for knee OA.

Keywords

Acknowledgement

The authors thank their mentor, Jeong-Gil Leem, MD, PhD (Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine), for his inspiring feedback and encouragement.

References

  1. Nguyen US, Zhang Y, Zhu Y, Niu J, Zhang B, Felson DT. Increasing prevalence of knee pain and symptomatic knee osteoarthritis: survey and cohort data. Ann Intern Med 2011; 155: 725-32. https://doi.org/10.7326/0003-4819-155-11-201112060-00004
  2. Bunt CW, Jonas CE, Chang JG. Knee pain in adults and adolescents: the initial evaluation. Am Fam Physician 2018; 98: 576-85.
  3. Jones BQ, Covey CJ, Sineath MH Jr. Nonsurgical management of knee pain in adults. Am Fam Physician 2015; 92: 875-83.
  4. Cui A, Li H, Wang D, Zhong J, Chen Y, Lu H. Global, regional prevalence, incidence and risk factors of knee osteoarthritis in population-based studies. EClinicalMedicine 2020; 29-30: 100587.
  5. Skou ST, Roos EM, Simonsen O, Laursen MB, Rathleff MS, Arendt-Nielsen L, et al. The efficacy of nonsurgical treatment on pain and sensitization in patients with knee osteoarthritis: a pre-defined ancillary analysis from a randomized controlled trial. Osteoarthritis Cartilage 2016; 24: 108-16. https://doi.org/10.1016/j.joca.2015.07.013
  6. Hagedorn JM, Wooster BM, Hunt CL, Moeschler SM, Orhurhu V, Trousdale RT. Beyond revision surgery: work-up and interventional treatments for the painful total knee arthroplasty. Pain Pract 2020; 20: 929-36. https://doi.org/10.1111/papr.12924
  7. Sweet WH, Mark VH, Hamlin H. Radiofrequency lesions in the central nervous system of man and cat: including case reports of eight bulbar pain-tract interruptions. J Neurosurg 1960; 17: 213-25. https://doi.org/10.3171/jns.1960.17.2.0213
  8. Shealy CN. Percutaneous radiofrequency denervation of spinal facets. Treatment for chronic back pain and sciatica. J Neurosurg 1975; 43: 448-51. https://doi.org/10.3171/jns.1975.43.4.0448
  9. Hong K, Georgiades C. Radiofrequency ablation: mechanism of action and devices. J Vasc Interv Radiol 2010; 21(8 Suppl): S179-86. https://doi.org/10.1016/j.jvir.2010.04.008
  10. Byrd D, Mackey S. Pulsed radiofrequency for chronic pain. Curr Pain Headache Rep 2008; 12: 37-41. https://doi.org/10.1007/s11916-008-0008-3
  11. Choi WJ, Hwang SJ, Song JG, Leem JG, Kang YU, Park PH, et al. Radiofrequency treatment relieves chronic knee osteoarthritis pain: a double-blind randomized controlled trial. Pain 2011; 152: 481-7. https://doi.org/10.1016/j.pain.2010.09.029
  12. Iannaccone F, Dixon S, Kaufman A. A review of longterm pain relief after genicular nerve radiofrequency ablation in chronic knee osteoarthritis. Pain Physician 2017; 20: E437-44. https://doi.org/10.36076/ppj.2017.E444
  13. Kolasinski SL, Neogi T, Hochberg MC, Oatis C, Guyatt G, Block J, et al. 2019 American College of Rheumatology/Arthritis Foundation Guideline for the management of osteoarthritis of the hand, hip, and knee. Arthritis Care Res (Hoboken) 2020; 72: 149-62. Erratum in: Arthritis Care Res (Hoboken) 2021; 73: 764.
  14. Brophy RH, Fillingham YA. AAOS Clinical Practice Guideline summary: management of osteoarthritis of the knee (nonarthroplasty), third edition. J Am Acad Orthop Surg 2022; 30: e721-9. https://doi.org/10.5435/JAAOS-D-21-01233
  15. Davis T, Loudermilk E, DePalma M, Hunter C, Lindley D, Patel N, et al. Prospective, multicenter, randomized, crossover clinical trial comparing the safety and effectiveness of cooled radiofrequency ablation with corticosteroid injection in the management of knee pain from osteoarthritis. Reg Anesth Pain Med 2018; 43: 84-91. https://doi.org/10.1097/AAP.0000000000000690
  16. Kapural L, Mekhail N. Radiofrequency ablation for chronic pain control. Curr Pain Headache Rep 2001; 5: 517-25. https://doi.org/10.1007/s11916-001-0069-z
  17. Gupta A, Huettner DP, Dukewich M. Comparative effectiveness review of cooled versus pulsed radiofrequency ablation for the treatment of knee osteoarthritis: a systematic review. Pain Physician 2017; 20: 155-71. https://doi.org/10.36076/ppj.2017.171
  18. Kapural L, Deering JP. A technological overview of cooled radiofrequency ablation and its effectiveness in the management of chronic knee pain. Pain Manag 2020; 10: 133-40. https://doi.org/10.2217/pmt-2019-0066
  19. Tran A, Reiter DA, Cruz AR, Gonzalez FM. Genicular nerve ablation review using cooled-radiofrequency nerve ablation. Semin Intervent Radiol 2022; 39: 130-7. https://doi.org/10.1055/s-0042-1745797
  20. Oladeji LO, Cook JL. Cooled radio frequency ablation for the treatment of osteoarthritis-related knee pain: evidence, indications, and outcomes. J Knee Surg 2019; 32: 65-71.
  21. Pilcher TA, Sanford AL, Saul JP, Haemmerich D. Convective cooling effect on cooled-tip catheter compared to large-tip catheter radiofrequency ablation. Pacing Clin Electrophysiol 2006; 29: 1368-74. https://doi.org/10.1111/j.1540-8159.2006.00549.x
  22. Farrell ME, Gutierrez G, Desai MJ. Demonstration of lesions produced by cooled radiofrequency neurotomy for chronic osteoarthritic knee pain: a case presentation. PM R 2017; 9: 314-7. https://doi.org/10.1016/j.pmrj.2016.09.001
  23. Lee DW, Pritzlaff S, Jung MJ, Ghosh P, Hagedorn JM, Tate J, et al. Latest evidence-based application for radiofrequency neurotomy (learn): best practice guidelines from the American Society of Pain and Neuroscience (ASPN). J Pain Res 2021; 14: 2807-31. https://doi.org/10.2147/JPR.S325665
  24. Maretto F, Vennik M, Albers KI, van Duijn B. TNFα secretion of monocytes exposed to pulsed radiofrequency treatment: a possible working mechanism of PRF chronic pain management. Pain Pract 2014; 14: 399-404. https://doi.org/10.1111/papr.12101
  25. Tanabe K, Takashima S, Iida H. Changes in the gene expression in mouse astrocytes induced by pulsed radiofrequency: a preliminary study. Neurosci Lett 2021; 742: 135536.
  26. Brasil LJ, Marroni N, Schemitt E, Colares J. Effects of pulsed radiofrequency on a standard model of muscle injury in rats. Anesth Pain Med 2020; 10: e97372.
  27. Hirasawa Y, Okajima S, Ohta M, Tokioka T. Nerve distribution to the human knee joint: anatomical and immunohistochemical study. Int Orthop 2000; 24: 1-4. https://doi.org/10.1007/s002640050001
  28. Kennedy JC, Alexander IJ, Hayes KC. Nerve supply of the human knee and its functional importance. Am J Sports Med 1982; 10: 329-35. https://doi.org/10.1177/036354658201000601
  29. Tran J, Peng PWH, Lam K, Baig E, Agur AMR, Gofeld M. Anatomical study of the innervation of anterior knee joint capsule: implication for image-guided intervention. Reg Anesth Pain Med 2018; 43: 407-14. https://doi.org/10.1097/AAP.0000000000000778
  30. Franco CD, Buvanendran A, Petersohn JD, Menzies RD, Menzies LP. Innervation of the anterior capsule of the human knee: implications for radiofrequency ablation. Reg Anesth Pain Med 2015; 40: 363-8. https://doi.org/10.1097/AAP.0000000000000269
  31. Yasar E, Kesikburun S, Kilic C, Guzelkucuk u, Yazar F, Tan AK. Accuracy of ultrasound-guided genicular nerve block: a cadaveric study. Pain Physician 2015; 18: E899-904. https://doi.org/10.36076/ppj.2015/18/E899
  32. Tran J, Peng P, Agur A. Evaluation of nerve capture using classical landmarks for genicular nerve radiofrequency ablation: 3D cadaveric study. Reg Anesth Pain Med 2020; 45: 898-906. https://doi.org/10.1136/rapm-2020-101894
  33. Kim JH, Shustorovich A, Arel AT, Downie SA, Cohen SP, Kim SY. Genicular nerve anatomy and its implication for new procedural approaches for knee joint denervation: a cadaveric study. Pain Med 2022; 23: 144-51. https://doi.org/10.1093/pm/pnab238
  34. Kim SY, Le PU, Kosharskyy B, Kaye AD, Shaparin N, Downie SA. Is genicular nerve radiofrequency ablation safe? A literature review and anatomical study. Pain Physician 2016; 19: E697-705. https://doi.org/10.36076/ppj/2019.19.E679
  35. Tran J, Peng PWH, Gofeld M, Chan V, Agur AMR. Anatomical study of the innervation of posterior knee joint capsule: implication for image-guided intervention. Reg Anesth Pain Med 2019; 44: 234-8. https://doi.org/10.1136/rapm-2018-000015
  36. Gonzalez FM. Cooled radiofrequency genicular neurotomy. Tech Vasc Interv Radiol 2020; 23: 100706.
  37. Khan FM, Tran A, Wong PK, Aiyedipe S, Loya MF, Cristescu MM, et al. Management of uncomplicated total knee arthroplasty chronic pain and stiffness utilizing cooled radiofrequency ablation: a single institution pilot study. Skeletal Radiol 2022; 51: 1215-23. https://doi.org/10.1007/s00256-021-03944-z
  38. Menzies RD, Hawkins JK. Analgesia and improved performance in a patient treated by cooled radiofrequency for pain and dysfunction postbilateral total knee replacement. 2015; 15: E54-8. https://doi.org/10.1111/papr.12292
  39. Narouze S, Benzon HT, Provenzano D, Buvanendran A, De Andres J, Deer T, et al. Interventional spine and pain procedures in patients on antiplatelet and anticoagulant medications (second edition): Guidelines from the American Society of Regional Anesthesia and Pain Medicine, the European Society of Regional Anaesthesia and Pain Therapy, the American Academy of Pain Medicine, the International Neuromodulation Society, the North American Neuromodulation Society, and the World Institute of Pain. Reg Anesth Pain Med 2018; 43: 225-62.
  40. Wong PK, Kokabi N, Guo Y, Reiter D, Reimer NB, Oskouei S, et al. Safety and efficacy comparison of three- vs four-needle technique in the management of moderate to severe osteoarthritis of the knee using cooled radiofrequency ablation. Skeletal Radiol 2021; 50: 739-50. https://doi.org/10.1007/s00256-020-03619-1
  41. Tran A, Reiter DA, Prologo JD, Cristescu M, Gonzalez FM. Review of extraosseous applications of thermal ablation in the treatment of moderate to severe large joint osteoarthritis. Semin Musculoskelet Radiol 2021; 25: 745-55. https://doi.org/10.1055/s-0041-1735474
  42. Tran A, Gonzalez FM. Review of cooled radiofrequency ablation utilization for the treatment of symptomatic advanced knee arthritis and total knee arthroplasty. Skeletal Radiol 2023; 52: 941-9. https://doi.org/10.1007/s00256-022-04058-w
  43. Tran J, Agur A, Peng P. Revisiting the anatomical evidence supporting the classical landmark of genicular nerve ablation. Reg Anesth Pain Med 2020; 45: 393-4. https://doi.org/10.1136/rapm-2019-101024
  44. Fonkoue L, Steyaert A, Kouame JK, Bandolo E, Lebleu J, Fossoh H, et al. A comparison of genicular nerve blockade with corticosteroids using either classical anatomical targets vs revised targets for pain and function in knee osteoarthritis: a doubleblind, randomized controlled trial. Pain Med 2021; 22: 1116-26. https://doi.org/10.1093/pm/pnab014
  45. Fonkoue L, Behets CW, Steyaert A, Kouassi JK, Detrembleur C, De Waroux BLP, et al. Accuracy of fluoroscopic-guided genicular nerve blockade: a need for revisiting anatomical landmarks. Reg Anesth Pain Med 2019; 44: 950-8. https://doi.org/10.1136/rapm-2019-100451
  46. Kim DH, Lee MS, Lee S, Yoon SH, Shin JW, Choi SS. A prospective randomized comparison of the efficacy of ultrasound- vs fluoroscopy-guided genicular nerve block for chronic knee osteoarthritis. Pain Physician 2019; 22: 139-46.
  47. Kim DH, Choi SS, Yoon SH, Lee SH, Seo DK, Lee IG, et al. Ultrasound-guided genicular nerve block for knee osteoarthritis: a double-blind, randomized controlled trial of local anesthetic alone or in combination with corticosteroid. Pain Physician 2018; 21: 41-52. https://doi.org/10.36076/ppj/2018.51
  48. McCormick ZL, Reddy R, Korn M, Dayanim D, Syed RH, Bhave M, et al. A prospective randomized trial of prognostic genicular nerve blocks to determine the predictive value for the outcome of cooled radiofrequency ablation for chronic knee pain due to osteoarthritis. Pain Med 2018; 19: 1628-38. https://doi.org/10.1093/pm/pnx286
  49. Parkes MJ, Callaghan MJ, O'Neill TW, Forsythe LM, Lunt M, Felson DT. Sensitivity to change of patient-preference measures for pain in patients with knee osteoarthritis: data from two trials. Arthritis Care Res (Hoboken) 2016; 68: 1224-31. https://doi.org/10.1002/acr.22823
  50. Bellini M, Barbieri M. Cooled radiofrequency system relieves chronic knee osteoarthritis pain: the first case-series. Anaesthesiol Intensive Ther 2015; 47: 30-3. https://doi.org/10.5603/AIT.2015.0003
  51. McCormick ZL, Korn M, Reddy R, Marcolina A, Dayanim D, Mattie R, et al. Cooled radiofrequency ablation of the genicular nerves for chronic pain due to knee osteoarthritis: six-month outcomes. Pain Med 2017; 18: 1631-41. https://doi.org/10.1093/pm/pnx069
  52. Rojhani S, Qureshi Z, Chhatre A. Water-cooled radiofrequency provides pain relief, decreases disability, and improves quality of life in chronic knee osteoarthritis. Am J Phys Med Rehabil 2017; 96: e5-8. https://doi.org/10.1097/PHM.0000000000000549
  53. Kapural L, Lee N, Neal K, Burchell M. Long-term retrospective assessment of clinical efficacy of radiofrequency ablation of the knee using a cooled radiofrequency system. Pain Physician 2019; 22: 489-94. https://doi.org/10.36076/ppj/2019.22.489
  54. Walega D, McCormick Z, Manning D, Avram M. Radiofrequency ablation of genicular nerves prior to total knee replacement has no effect on postoperative pain outcomes: a prospective randomized sham-controlled trial with 6-month follow-up. Reg Anesth Pain Med 2019; 44: 646-51. https://doi.org/10.1136/rapm-2018-100094
  55. Davis T, Loudermilk E, DePalma M, Hunter C, Lindley DA, Patel N, et al. Twelve-month analgesia and rescue, by cooled radiofrequency ablation treatment of osteoarthritic knee pain: results from a prospective, multicenter, randomized, cross-over trial. Reg Anesth Pain Med 2019; 44: 499-506. https://doi.org/10.1136/rapm-2018-100051
  56. Chen AF, Khalouf F, Zora K, DePalma M, Kohan L, Guirguis M, et al. Cooled radiofrequency ablation compared with a single injection of hyaluronic acid for chronic knee pain: a multicenter, randomized clinical trial demonstrating greater efficacy and equivalent safety for cooled radiofrequency ablation. J Bone Joint Surg Am 2020; 102: 1501-10. https://doi.org/10.2106/JBJS.19.00935
  57. Eshraghi Y, Khan R, Said O, Velasco C, Guirguis M. Cooled radiofrequency ablation of the genicular nerves for treatment of chronic knee pain. Reg Anesth Pain Med 2021; 46: 735-6. https://doi.org/10.1136/rapm-2020-101502
  58. Kocayigit H, Beyaz SG. Comparison of cooled and conventional radiofrequency applications for the treatment of osteoarthritic knee pain. J Anaesthesiol Clin Pharmacol 2021; 37: 464-8. https://doi.org/10.4103/joacp.JOACP_126_19
  59. Wu BP, Grits D, Foorsov V, Xu J, Tankha P, Bolash RB. Cooled and traditional thermal radiofrequency ablation of genicular nerves in patients with chronic knee pain: a comparative outcomes analysis. Reg Anesth Pain Med 2022; 47: 685-90. https://doi.org/10.1136/rapm-2022-103693
  60. Wu L, Li Y, Si H, Zeng Y, Li M, Liu Y, et al. Radiofrequency ablation in cooled monopolar or conventional bipolar modality yields more beneficial shortterm clinical outcomes versus other treatments for knee osteoarthritis: a systematic review and network meta-analysis of randomized controlled trials. Arthroscopy 2022; 38: 2287-302. https://doi.org/10.1016/j.arthro.2022.01.048
  61. Kapural L, Minerali A, Sanders M, Matea M, Dua S. Cooled radiofrequency ablation provides prolonged pain relief compared to traditional radiofrequency ablation: a real-world, large retrospective clinical comparison from a single practice. J Pain Res 2022; 15: 2577-86. https://doi.org/10.2147/JPR.S373877
  62. Vallejo R, Benyamin R, Orduna-Valls J, Vallejo A, Thomas SM, Cedeno DL. A randomized controlled study of the long-term efficacy of cooled and monopolar radiofrequency ablation for the treatment of chronic pain related to knee osteoarthritis. Interventional Pain Medicine 2023; 2: 100249.
  63. Vanneste T, Belba A, Kallewaard JW, van Kuijk SMJ, Gelissen M, Emans P, et al. Comparison of cooled versus conventional radiofrequency treatment of the genicular nerves for chronic knee pain: a multicenter non-inferiority randomized pilot trial (COCOGEN trial). Reg Anesth Pain Med 2023; 48: 197-204. https://doi.org/10.1136/rapm-2022-104054
  64. Caragea M, Woodworth T, Curtis T, Blatt M, Cheney C, Brown T, et al. Genicular nerve radiofrequency ablation for the treatment of chronic knee joint pain: a real-world cohort study with evaluation of prognostic factors. Pain Med 2023; 24: 1332-40. https://doi.org/10.1093/pm/pnad095
  65. Khanna A, Knox N, Sekhri N. Septic arthritis following radiofrequency ablation of the genicular nerves. Pain Med 2019; 20: 1454-6. https://doi.org/10.1093/pm/pny308
  66. McCormick ZL, Walega DR. Third-degree skin burn from conventional radiofrequency ablation of the inferiomedial genicular nerve. Pain Med 2018; 19: 1095-7. https://doi.org/10.1093/pm/pnx204
  67. Ghai B, Kumar M, Makkar JK, Goni V. Comparison of ultrasound guided pulsed radiofrequency of genicular nerve with local anesthetic and steroid block for management of osteoarthritis knee pain. Korean J Pain 2022; 35: 183-90.  https://doi.org/10.3344/kjp.2022.35.2.183