Coolief Cooled Radiofrequency vs. Conventional Radiofrequency to Manage OA Knee Pain

Avanos Medical

Status

Completed

Conditions

Osteoarthritis of the Knee

Treatments

Device: Standard Radiofrequency

Device: Cooled Radiofrequency

Study type

Interventional

Funder types

Other

Identifiers

NCT04145011

105-18-0002

Details and patient eligibility

About

This study is being performed to assess the relative effectiveness of genicular nerve ablation with the COOLIEF* Cooled Radiofrequency probe to manage moderate to severe knee pain in patients with osteoarthritis (OA) of the knee when compared to radiofrequency ablation using a Standard Radiofrequency probe.

Full description

This is a prospective, multi-center, randomized, single-blind comparison study examining the outcomes of subjects with osteoarthritic knee pain undergoing a procedure to create a radiofrequency lesion of the genicular nerves with either Cooled Radiofrequency Ablation (CRFA) or Conventional (Standard) Radiofrequency Ablation (SRFA). Approximately 148 participants from up to 15 sites will be enrolled into this study, with subjects undergoing either CRFA or SRFA in a 1:1 randomization scheme. Follow-up will be conducted for 24 months post-treatment, with the primary endpoint being completed at month 12. Pain, overall outcome, quality of life, pain medication use, and adverse events will be compared between the two treatment groups to determine success.

Enrollment

153 patients

Sex

All

Ages

21+ years old

Volunteers

No Healthy Volunteers

Inclusion criteria

Age ≥ 21 years
Able to understand and personally sign and date the informed consent form
Able to complete outcome measures
Chronic knee pain for longer than 6 months that interferes with functional activities (for example, ambulation, prolonged standing, etc.)
Continued pain in the target knee despite at least 3 months of conservative treatments, including activity modification, home exercise, protective weight bearing, and/or analgesics (for example, acetaminophen or non-steroidal anti-inflammatory drugs [NSAIDs])
Positive response (defined as a decrease in numeric pain scores of at least 50%) to a single genicular nerve block of the index knee
Pain on NRS ≥ 6 on an 11-point scale for the index knee
Radiologic confirmation of osteoarthritis (x-ray/MRI/CT) grade 2 (mild), 3 (moderate) or 4 (severe) noted within 6 months for the index knee
Analgesics including membrane stabilizers such as Neurontin (gabapentin) and antidepressants for pain, such as Cymbalta (duloxetine), must be clinically stable (defined as stable dosage for ≥ 6 weeks prior to the screening visit) and shall not change during the course of the study without approval of the investigator
Agree to see one physician (study physician) for knee pain during the study period
Subjects of child bearing potential must be willing to utilize double barrier contraceptive method
Willingness to comply with the requirements of this protocol for the full duration of the study (24 months regardless of effect of initial therapy)

Exclusion criteria

Evidence of inflammatory arthritis (example, rheumatoid arthritis) or other systemic inflammatory condition (example; gout, fibromyalgia, MS, Lupus, etc.) that could cause knee pain
Evidence of neuropathic pain affecting the index knee
Previous or pending lower limb amputation
Intra-articular steroid injection into the index knee within 90 days from randomization
Hyaluronic acid injection, platelet rich plasma (PRP), stem cell, or arthroscopic debridement/lavage injection into the index knee within 180 days from randomization
Prior radiofrequency ablation of the genicular nerves of the index knee
Prior partial, resurfacing, or total knee arthroplasty of the index knee (residual hardware)
Clinically significant ligamentous laxity of the index knee
Clinically significant valgus/varus deformities or evidence of pathology (other than osteoarthritis of knee) that materially affects gait or function of the knee or is the underlying cause of the knee pain and/or functional limitations
Body mass index (BMI) > 40 kg/m2
Extremely thin patients and those with minimal subcutaneous tissue thickness that would not accommodate a radiofrequency lesion of up to 14 mm in diameter to limit the risk of skin burns
Pending or active compensation claim, litigation, or disability remuneration (secondary gain)
Pregnant, nursing or intent of becoming pregnant during the study period
Chronic pain associated with significant psychosocial dysfunction
Poorly controlled severe psychiatric illness or ongoing psychological barriers to recovery, as determined by the investigator
Allergies to any of the medications to be used during the procedures
Active joint infection or systemic or localized infection at needle entry sites (subject may be considered for inclusion once infection is resolved)
History of uncontrolled coagulopathy, ongoing coagulation treatment that cannot be safely interrupted for procedure, or unexplained or uncontrollable bleeding that is uncorrectable
Identifiable anatomical variability that would materially alter the procedure as described in the protocol
Within the preceding 2 years, subject has suffered from active narcotic addiction, substance, or alcohol abuse
Current prescribed opioid medications greater than 60 mg morphine equivalent daily opioid dose
Uncontrolled immunosuppression (e.g. AIDS, cancer, diabetes, etc.)
Subject currently implanted with pacemaker, stimulator or defibrillator
Participating in another clinical trial/investigation which included therapeutic treatment within 30 days prior to signing informed consent
Subject unwilling or unable to comply with follow up schedule, protocol requirements or procedures