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Effectiveness of Combined Treatment Using Physical Exercise and Ultrasound-Guided Radiofrequency Ablation of Genicular Nerves in Patients with Knee Osteoarthritis
Applied Sciences ( IF 2.838 ) Pub Date : 2021-05-11 , DOI: 10.3390/app11104338
Alessandro de Sire , Lorenzo Lippi , Claudio Curci , Dario Calafiore , Carlo Cisari , Antonio Ammendolia , Marco Invernizzi

Radiofrequency (RF) is a mini-invasive neuromodulation intervention that is commonly used in chronic pain conditions including general musculoskeletal pain related to several diseases, including knee osteoarthritis (KOA). However, to date, few studies investigated synergistic therapeutic approaches combining RF with rehabilitative physical exercise protocols in KOA patients. This prospective cohort study aimed at assessing the short-term effects on pain in KOA patients of a multimodal intervention consisting of ultrasound (US)-guided RF geniculate ablation and concomitant rehabilitative physical exercise. We included grade III KOA patients with knee pain (Numerical Pain Rating Scale, NPRS >4) not responsive to conventional treatments. They underwent a combined intervention including US-guided RF geniculate ablation and a 2-week physical exercise program. At the baseline (T0) and 1 month after (T1) we assessed: NPRS, Knee Injury and Osteoarthritis Outcome Scale (KOOS), quality of life, exercise adherence, and safety. All the 47 KOA patients enrolled (68.8 ± 13.7 years old) showed a reduction of pain (NPRS: 7.48 ± 1.74; 3.63 ± 1.68; p < 0.001). In addition, there was a significant improvement (p < 0.05) also in the other functioning and HRQoL outcomes. Adherence to the exercise program was over 80% in more than half (28) of the patients. No major adverse events were reported. These findings suggested that US-guided RF ablation of genicular nerves combined with rehabilitative exercise therapy might be considered a safe and effective approach in the complex management of KOA patients.

中文翻译:

膝关节骨关节炎患者体育锻炼和超声引导下的射频消融联合治疗膝关节骨性关节炎的疗效

射频(RF)是一种微创神经调节干预措施,通常用于慢性疼痛状况,包括与几种疾病(包括膝骨关节炎(KOA))相关的一般性肌肉骨骼疼痛。但是,迄今为止,很少有研究研究在KOA患者中将RF与康复性体育锻炼方案相结合的协同治疗方法。这项前瞻性队列研究旨在评估一种多模式干预措施(包括超声(US)引导的射频膝状消融术和伴随的康复体育锻炼)对KOA患者疼痛的短期影响。我们纳入了对传统疗法无反应的膝关节疼痛(数字疼痛评分量表,NPRS> 4)的III级KOA患者。他们接受了联合干预,包括美国指导的射频膝状消融术和为期2周的体育锻炼计划。在基线(T0)和术后1个月(T1),我们评估了:NPRS,膝关节损伤和骨关节炎结果量表(KOOS),生活质量,运动依从性和安全性。入组的所有47名KOA患者(68.8±13.7岁)均表现出疼痛减轻(NPRS:7.48±1.74; 3.63±1.68;p <0.001)。此外,其他功能和HRQoL结果也有显着改善(p <0.05)。在一半以上(28)的患者中,坚持锻炼计划的比例超过了80%。没有重大不良事件的报道。这些发现表明,在KOA患者的复杂治疗中,US引导的icular神经射频消融结合康复运动疗法可能被认为是一种安全有效的方法。
更新日期:2021-05-11
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