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Comparison between fluoroscopy-guided radiofrequency ablation of genicular nerves and intra-articular injection of steroid in relieving pain and improving function among candidates of knee replacement surgery: A randomized controlled trial
Margaret Chabungbam1, Akoijam J Singh2, Longjam N Singh2, Chandrakant Pilania3, Sreejith Choorapra4, Tripti Swami5, Kanti Rajkumari6
1 Department of Physical Medicine & Rehabilitation, AIIMS, New Delhi, India
2 Department of Physical Medicine & Rehabilitation, RIMS, Imphal, Manipur, India
3 Department of Physical Medicine & Rehabilitation, AIIMS, Jodhpur, Rajasthan, India
4 Thanal Brain & Spine Medcity, Kannur, Kerala, India
5 Department of Physical Medicine & Rehabilitation, Christian Medical College and Hospital, Chittoor, Andhra Pradesh, India
6 Department of Physical Medicine & Rehabilitation, Churachandpur Medical College, Manipur, India
Correspondence Address:
Dr. Kanti Rajkumari
Department of Physical Medicine & Rehabilitation, Churachandpur Medical College, Churachandpur 795128, Manipur
India
 Source of Support: None, Conflict of Interest: None
DOI: 10.4103/JOASP.JOASP_20_22
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BACKGROUND: Osteoarthritis (OA) is the second most common rheumatologic problem in India. Prevalence of OA in India is 22–39% and knee OA alone contributes to 80% of OA burden. Despite the immense impact of this disease, very few effective non-surgical treatment options are available. The present study aims to compare fluoroscopy-guided radiofrequency ablation (RFA) of genicular nerves with intra-articular (IA) injection of methylprednisolone acetate in relieving pain and improving function in Grade 3 and 4 OA of knee. MATERIALS AND METHODS: A randomized controlled trial was done in the Department of Physical Medicine and Rehabilitation, Regional Institute of Medical Sciences for a period of 1 year on 76 patients with knee OA Kellgren–Lawrence (KL) grade 3 and 4. They were divided into two groups: study and control groups. The study group underwent RFA of genicular nerves of knee, whereas the control group received IA knee injection with methylprednisolone acetate 80 mg. Assessments of Visual Analog Scale (VAS) and Western Ontario McMaster University Osteoarthritis Index (WOMAC) were done at 1, 4, and 12 weeks. RESULTS: The study group showed a decrease in VAS score from 6.84 ± 0.638 at baseline to 2.61 ± 0.718 at 1 week and 2.97 ± 0.885 at 12 weeks. The control group showed a decrease in VAS score from 5.82 ± 0.563 at baseline to 2.18 ± 0.393 at 1 week and 4.03 ± 0.545 at 12 weeks. WOMAC function score improved from 44.79 ± 7.185 at baseline to 26.79 ± 4.375 at 12 weeks in the RFA group, whereas in the steroid group it improved from 41.26 ± 5.310 at baseline 24.89 ± 3.431 at 12 weeks (P<0.05). CONCLUSION: RFA of genicular nerve can be used as an effective modality for providing cost-effective and long-standing pain relief in patients with KL Grade 3 and 4 OA knee who are unable to undergo knee replacement surgery. |
