Ultrasound-guided Monopolar Versus Bipolar Radiofrequency Ablation for Genicular Nerves in Chronic Knee Osteoarthritis

Mansoura University

Status: Unknown

Conditions: Chronic Knee Osteoarthritis

Treatments: Procedure: Bipolar radiofrequency ablation; Procedure: Monopolar radiofrequency ablation

Study type: Interventional

Funder types: Other

Identifiers

NCT04112264

MD.19.03.152

Details and patient eligibility

About

Radiofrequency ablation of the genicular nerves using ultrasound is safe and effective for treating intractable knee osteoarthritis pain by using either monopolar or bipolar radiofrequency ablation.

This technique is based on anatomical studies demonstrating that genicular nerves are accompanied by genicular arteries. Ultrasound-guided RF genicular ablation yielded both significant reductions in knee pain and improvements in functional capacity.

Full description

The aim of this study is to compare between ultrasound guided monopolar and bipolar radiofrequency ablation in chronic knee osteoarthritis.

Osteoarthritis of knee joint is one of the most common disease conditions with advanced age and leads to considerable morbidity in terms of pain, stiffness, limitation in functions, disturbance in sleep and psychological disturbance

A diagnostic genicular nerve block (GNB) with local anesthetic is performed before RF genicular ablation, and a successful response to GNB is considered to indicate the need for RF genicular ablation

Enrollment: 50 estimated patients

Sex: All

Ages: 40 to 70 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Radiologic tibiofemoral Osteoarthritis (Kellgren-Lawrence grade 2-4).
• Patients not responding to other treatments as physiotherapy, oral analgesics, and intraarticular injection with hyaluronic acids or steroids.
• Patients refused surgery.

Exclusion criteria

• Patient refusal.
• Prior knee surgery.
• Acute knee pain.
• Intra-articular knee corticosteroid or hyaluronic acid injection in the past 3 months.
• Connective tissue diseases that affected the knee.
• Anticoagulant medication use.
• Local skin infection and sepsis at the site of intervention

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

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50 participants in 2 patient groups

Monopolar radiofrequency ablation

Experimental group

Description:

Patients will receive ultrasound-guided monopolar radiofrequency ablation

Treatment:

Procedure: Monopolar radiofrequency ablation

Bipolar radiofrequency ablation

Active Comparator group

Description:

Patients will receive ultrasound-guided bipolar radiofrequency ablation

Treatment:

Procedure: Bipolar radiofrequency ablation