Rev. Soc. Esp. Dolor. 2021; 28(3): 154-168 / DOI: 10.20986/resed.2021.3900/2021
John Carlos Pérez, Diana Carolina Nájera, Manuel Herrero, Rafael Gálvez, Manuel Alejandro Sánchez, Alberto Vela, Ramón López
ABSTRACT
Introduction: The use of genicular nerve radiofrequency procedures to treat chronic knee pain due to osteoarthritis has surged in 2011, though many questions remain regarding anatomical targets, selection criteria, and evidence for effectiveness.
Materials and methods: An electronic search was performed from January 2011 to April 2020. Databases searched included PubMed®, Embase®, Google Scholar and Web of Science (WoS). The initial search found 106 articles. Thirty-three articles were taken for this review.
Results: After analyzing five open clinical trials, one cross-sectional study, four prospective observational studies, eight neuroanatomy studies, three retrospective studies, four clinical cases, two case series, three literature reviews and three randomized, double blind, controlled trials; we found genicular nerve radiofrequency achieves a pain reduction and functional improvement with a variable duration, between three and twelve months. There is no consensus regarding the neuroanatomy of the knee joint capsule, the location of the targets, the radiofrequency parameters used and the usefulness of diagnostic blocks.
Conclusion: More clinical trials are needed to standardize the parameters used and confirm the positive results of genicular nerve radiofrequency. Although lonthere are few cases of adverse events associated with radiofrequency of the geniculate nerves, more studies are needed to support the safety of this technique and its long-term side effects in osteoarthritis knee pain management associated that do not respond to other previous medical treatments.
RESUMEN
Introducción: El uso de radiofrecuencia de los nervios geniculados para el tratamiento del dolor crónico de la rodilla secundario a osteoartrosis inició en 2011, y desde entonces se han realizado varios estudios con diferentes metodologías. Sin embargo, continúan generándose muchas dudas con respecto a las dianas anatómicas, los criterios de selección y la evidencia de su efectividad.
Materiales y métodos: Se realizó una búsqueda electrónica desde enero de 2011 hasta abril de 2020 en las siguientes bases de datos: PubMed®, Embase ®, Google Académico y Web of Science (WoS). La búsqueda inicial encontró 106 artículos, de los cuales tomamos 33 para realizar la presente revisión.
Resultados: Después de analizar cinco ensayos clínicos abiertos, un estudio de corte transversal, cuatro estudios prospectivos observacionales, ocho estudios de neuroanatomía, tres estudios retrospectivos, cuatro casos clínicos, dos series de casos, tres revisiones de la literatura y tres ensayos clínicos aleatorizados, controlados y doble ciegos; encontramos que la radiofrecuencia de los nervios geniculados disminuye el dolor asociado a la osteoartrosis de rodilla, consiguiendo una mejoría funcional con una duración variable del efecto analgésico entre tres y doce meses. A pesar del avance científico en esta área, aún no hay un consenso en cuanto a la neuroanatomía de la cápsula articular de la rodilla, la ubicación de las dianas, los parámetros empleados en radiofrecuencia y la utilidad de los bloqueos diagnósticos.
Conclusiones: Se necesitan más ensayos clínicos que estandaricen los parámetros utilizados y confirmen los resultados positivos de los estudios realizados con radiofrecuencia de los nervios geniculados. Aunque son pocos los casos de eventos adversos asociados a la radiofrecuencia de los nervios geniculados, necesitamos más estudios que avalen la seguridad de esta técnica y sus efectos secundarios a largo plazo en el tratamiento del dolor crónico de la rodilla secundario a osteoartrosis que no responde a otros tratamientos.
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Bibliografía
Bannuru RR, Osani MC, Vaysbrot EE, Arden NK, Bennell K, Bierma-Zeinstra SMA, et al. OARSI guidelines for the non-surgical management of knee, hip, and polyarticular osteoarthritis. Osteoarthr Cartil. 2019;27(11):1578-89.
2. Seoane-Mato D, Sánchez-Piedra C, Silva-Fernández L, Sivera F, Blanco FJ, Pérez Ruiz F, et al. Prevalence of rheumatic diseases in adult population in Spain (EPISER 2016 study): Aims and methodology. Reumatol Clin. 2019;15(2):90-6.
3. Zhang W, Moskowitz RW, Nuki G, Abramson S, Altman RD, Arden N, et al. OARSI recommendations for the management of hip and knee osteoarthritis, Part II: OARSI evidence-based, expert consensus guidelines. Osteoarthr Cartil. 2008;16(2):137-62.
4. Wylde V, Hewlett S, Learmonth ID, Dieppe P. Persistent pain after joint replacement: Prevalence, sensory qualities, and postoperative determinants. Pain 2011;152(3):566-72.
5. Ramírez Ogalla I, Moreno Martín A, Santana Pineda MM, Rodríguez Huertas F. Eficacia de la radiofrecuencia convencional de geniculados para el tratamiento del dolor en gonartrosis moderada-severa. Rev Soc Esp Dolor. 2014;21(4):212-8.
6. Cosman ER, Cosman ER. Electric and thermal field effects in tissue around radiofrequency electrodes. Pain Med. 2005;6(6):405-24.
7. Ward E, Munk PL, Rashid F, Torreggiani WC. Musculoskeletal Interventional Radiology: Radiofrequency Ablation. Radiol Clin North Am. 2008;46(3):599-610.
8. Cosman ER, Dolensky JR, Hoffman RA. Original Research Articles Factors That Affect Radiofrequency Heat Lesion Size. Pain Med. 2014;15(12):2020-36.
9. Choi WJ, Hwang SJ, Song JG, Leem JG, Kang YU, Park PH, et al. Radiofrequency treatment relieves chronic knee osteoarthritis pain: A double-blind randomized controlled trial. Pain. 2011;152(3):481-7.
10. Franco CD, Buvanendran A, Petersohn JD, Menzies RD, Menzies LP. Innervation of the Anterior Capsule of the Human Knee: Implications for Radiofrequency Ablation. Reg Anesth Pain Med. 2015;40(4):363-8.
11. Tran J, Peng PWH, Gofeld M, Chan V, Agur AMR. Anatomical study of the innervation of posterior knee joint capsule: Implication for image-guided intervention. Reg Anesth Pain Med. 2019;44(2):234-8.
12. Valls JMO, Vallejo R, Pais PL, Soto E, Rodríguez DT, Cedeño DL, et al. Anatomic and ultrasonographic evaluation of the knee sensory innervation a cadaveric study to determine anatomic targets in the treatment of chronic knee pain. Reg Anesth Pain Med. 2017;42(1):90-8.
13. Tran J, Peng PWH, Lam K, Baig E, Agur AMR, Gofeld M. Anatomical Study of the Innervation of Anterior Knee Joint Capsule: Implication for Image-Guided Intervention. Reg Anesth Pain Med. 2018;43(4):407-14.
14. Pineda MMS, Vanlinthout LE, Martín AM, Van Zundert J, Huertas FR, Ruiz JPN. Analgesic effect and functional improvement caused by radiofrequency treatment of genicular nerves in patients with advanced osteoarthritis of the knee until 1 year following treatment. Reg Anesth Pain Med. 2017;42(1):62-8.
15. Iannaccone F, Dixon S, Kaufman A. A review of long-term pain relief after genicular nerve radiofrequency ablation in chronic knee osteoarthritis. Pain Physician. 2017;20(3):E437-44.
16. Kim DH, Lee MS, Lee S, Yoon SH, Shin JW, Choi SS. A prospective randomized comparison of the efficacy of ultrasound- vs fluoroscopy- guided genicular nerve block for chronic knee osteoarthritis. Pain Physician. 2019;22(2):139-46.
17. Kwon SS, Chazen JL, Kishore S, Habibi BA, Chi M, Rand E, et al. Investigation of genicular neurotomy of the knee: MRI characterization of anatomy and implications for intervention. Clin Imaging. 2020;59(1):78-83.
18. Fonkoué L, Behets C, Kouassi JÉK, Coyette M, Detrembleur C, Thienpont E, et al. Distribution of sensory nerves supplying the knee joint capsule and implications for genicular blockade and radiofrequency ablation: an anatomical study. Surg Radiol Anat. 2019;41(12):1461-71.
19. Lash D, Frantz E, Hurdle MF. Ultrasound-guided cooled radiofrequency ablation of the genicular nerves: a technique paper. Pain Manag. 2020;10(3):147-57.
20. Yasar E, Kesikburun S, Kılıç C, Güzelküçük Ü, Yazar F, Tan AK. Accuracy of ultrasound-guided genicular nerve block: A cadaveric study. Pain Physician. 2015;18(5):E899-904.
21. Kim DH, Choi SS, Yoon SH, Lee SH, Seo DK, Lee IG, et al. Ultrasound-guided genicular nerve block for knee osteoarthritis: A double-blind, randomized controlled trial of local anesthetic alone or in combination with corticosteroid. Pain Physician. 2018;21(1):41-51.
22. McCormick ZL, Reddy R, Korn M, Dayanim D, Syed RH, Bhave M, et al. A prospective randomized trial of prognostic genicular nerve blocks to determine the predictive value for the outcome of cooled radiofrequency ablation for chronic knee pain due to osteoarthritis. Pain Med. 2018;19(8):1628-38.
23. Cushman DM, Monson N, Conger A, Kendall RW, Henrie AM, McCormick ZL. Use of 0.5 mL and 1.0 mL of local anesthetic for genicular nerve blocks. Pain Med. 2019;20(5):1049-52.
24. Qudsi-Sinclair S, Borrás-Rubio E, Abellan-Guillén JF, Padilla del Rey ML, Ruiz-Merino G. A Comparison of Genicular Nerve Treatment Using Either Radiofrequency or Analgesic Block with Corticosteroid for Pain after a Total Knee Arthroplasty: A Double-Blind, Randomized Clinical Study. Pain Pract. 2017;17(5):578-88.
25. El-Hakeim EH, Elawamy A, Kamel EZ, Goma SH, Gamal RM, Ghandour AM, et al. Fluoroscopic guided radiofrequency of genicular nerves for pain alleviation in chronic knee osteoarthritis: A single-blind randomized controlled trial. Pain Physician. 2018;21(2):169-77.
26. Konya ZY, Akin Takmaz S, Başar H, Baltaci B, Babaoğlu G. Results of genicular nerve ablation by radiofrequency in osteoarthritis-related chronic refractory knee pain. Turkish J Med Sci. 2020;50(1):86-95.
27. Protzman NM, Gyi J, Malhotra AD, Kooch JE. Examining the feasibility of radiofrequency treatment for chronic knee pain after total knee arthroplasty. PM R. 2014;6(4):373-6.
28. Jamison DE, Cohen SP. Radiofrequency techniques to treat chronic knee pain: A comprehensive review of anatomy, effectiveness, treatment parameters, and patient selection. J Pain Res. 2018;11:1879-88.
29. McCormick ZL, Walega DR. Third-degree skin burn from conventional radiofrequency ablation of the inferiomedial genicular nerve. Pain Med. 2018;19(5):1095-97.
30. Khanna A, Knox N, Sekhri N. Septic Arthritis following Radiofrequency Ablation of the Genicular Nerves. Pain Med. 2019;20(7):1454-56.
31. Kim SY, Le PU, Kosharskyy B, Kaye AD, Shaparin N, Downie SA. Is genicular nerve radiofrequency ablation safe? A literature review and anatomical study. Pain Physician. 2016;19(5):E697-705.
32. Strand N, Jorge P, Freeman J, D’Souza RS. A rare complication of knee hematoma after genicular nerve radiofrequency ablation. Pain Reports. 2019;4(3):E736.
33. De Lima DA, Gonçalves MCK, Sá Grando STC, De Lima Cintra TL, Pinto DM, Gonçalves RK. Indications of the neurotomy of genicular nerves by radiofrequency for the treatment of knee osteoarthritis: A literature review. Rev Bras Ortop. 2019;54(3):233-40.
34. Tran J, Agur A, Peng P. Revisiting the anatomical evidence supporting the classical landmark of genicular nerve ablation. Reg Anesth Pain Med. 2020;45(5):393-94.
35. Menzies RD, Hawkins JK. Analgesia and Improved Performance in a Patient Treated by Cooled Radiofrequency for Pain and Dysfunction Postbilateral Total Knee Replacement. Pain Pract. 2015;15(6):E54-8.
36. Jadon A, Jain P, Motaka M, Swarupa CP, Amir M. Comparative evaluation of monopolar and bipolar radiofrequency ablation of genicular nerves in chronic knee pain due to osteoarthritis. Indian J Anaesth. 2018;62(11):876-80.
37. Arican S, Hacibeyoglu G, Akkoyun Ö, Uzun ST, Reisli R. Fluoroscopy-guided genicular nerves pulsed radiofrequency for chronic knee pain treatment. Agri. 2020;32(1):38-43.
38. Kesikburun S, Yaşar E, Uran A, Adigüzel E, Yilmaz B. Ultrasound-guided genicular nerve pulsed radiofrequency treatment for painful knee osteoarthritis: A preliminary report. Pain Physician. 2016;19(5):E751-9.
39. Ikeuchi M, Ushida T, Izumi M, Tani T. Percutaneous Radiofrequency Treatment for Refractory Anteromedial Pain of Osteoarthritic Knees. Pain Med. 2011;12(4):546-51.