Thermal Radiofrequency Neurolysis Versus Alcoholic Neurolysis of the Genicular Nerves for Treatment of Chronic Knee Pain in Advanced Knee Osteoarthritis

Tanta University

Status: Completed

Conditions: Chronic Knee Pain; Advanced Knee Osteoarthritis; Treatment; Thermal Radiofrequency Neurolysis; Genicular Nerves; Alcoholic Neurolysis

Treatments: Other: Alcoholic Neurolysis; Other: Thermal Radiofrequency Neurolysis

Study type: Interventional

Funder types: Other

Identifiers

NCT07125768

36264MS603/5/24

Details and patient eligibility

About

This study aimed to compare the strength and duration of pain relief, quality of life and analgesic consumption between patients who undergo conventional thermal radiofrequency vs patients who undergo chemical neurolysis on genicular nerves by alcohol in chronic knee osteoarthritis pain.

Full description

Knee osteoarthritis is a degenerative joint disease characterized by the degradation of the articular cartilage, with many factors implicated in the disease pathogenesis.

Chronic pain of knee osteoarthritis is a common clinical symptom leading to restricted movement, disability, psychological distress, and impaired quality of life.

The targeted genicular nerves are those that had a close topographic relationship with the bone cortical surfaces, such as the femoral epicondyles (Superior medial [SM] and Superior lateral [SL] genicular nerves) and the medial tibial epicondyle (Inferior medial [IM] genicular nerve).

Nerve ablation causes iatrogenic neural degeneration, aiming only for sensory or sympathetic denervation without motor deficits. The nerve ablation methods currently available are performed by either thermal ablation using radiofrequency or chemical ablation using alcohol or phenol.

Chemical neurolysis techniques can be an effective method to accomplish a larger, more thorough lesioning than radiofrequency ablation and are capable of covering the anatomical variability of genicular nerves, so ensuring a better success rate and outcome with less cost and less logistic support.

Enrollment: 70 patients

Sex: All

Ages: 40 to 60 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Age from 40 to 60 years.
• Both sexes.
• Stage 3 and 4 knee osteoarthritis in patients who aren't responding to pharmacological treatment and aren't good candidates for knee replacement surgery.

Exclusion criteria

• Neurological disorders (Previous cerebrovascular stroke, neuropathy, or weakness).
• Bleeding disorders.
• Infection at or near the injection site.
• Presence of a pacemaker or defibrillator.
• Acute knee injury.
• Unstable knee joint.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

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70 participants in 2 patient groups

Group I

Experimental group

Description:

Patients received C-arm guided neurolysis of superior medial \[SM\], superior lateral \[SL\], and inferior medial \[IM\] genicular nerves by thermal radiofrequency.

Treatment:

Other: Thermal Radiofrequency Neurolysis

Group II

Active Comparator group

Description:

Patients received C-arm guided injection of each of the three genicular nerves with 1 ml of a solution containing 70% alcohol in 0.25% lidocaine.

Treatment:

Other: Alcoholic Neurolysis