Functional Outcome and Pain Relief After Pulsed Radiofrequency of Saphenous Nerve in Medial Compartment Knee Osteoarthritis: A Randomised Double-Blind Trial

Jadon Ashok
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Abstract

Background and aims: Pulsed radiofrequency (PRF) of saphenous nerve (SN) has shown effective pain relief in knee pain due to knee osteoarthritis (KOA). Since adductor canal (AC) contains other sensory nerves innervating the medial part of knee joint apart from SN. We compared the PRF of SN within and outside the AC for their quality and duration of pain relief in knee osteoarthritis of medial compartment (KOA-MC). Methods: We conducted a randomised prospective study in 60 patients with anteromedial knee pain due to KOA-MC. Patients in group A received PRF-SN and those in group B, PRF-AC. Primary objectives were, comparison of pain by visual analogue scale (VAS) score and changes in quality of daily living by Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and OXFORD knee scores (OKS). Secondary objectives were, comparison of analgesic requirements using Medicine Quantification Scale (MQS) scale and block related complications. Intra group comparison was done by Analysis of variance (ANOVA). Inter group normally distributed data was assessed by student's t-test, non-normally distributed and ordinal data by Mann-Whitney U-test and categorical data by Chi-square test. A p value of < 0.05 was considered significant. Results: VAS scores were significantly lower in Gr-B at 12 weeks. The WOMAC scores and OXFORD scores at 4, 8, 12 and 24 weeks were significantly lower in Gr-B compared to Gr-A. Conclusion: The PRF-AC provides better pain relief and functional outcome than PRF-SN however, duration of pain relief was not significantly different.
内隔膝骨关节炎隐神经脉冲射频治疗后的功能结局和疼痛缓解:一项随机双盲试验
背景和目的:脉冲射频(PRF)治疗隐神经(SN)可有效缓解膝骨关节炎(KOA)所致的膝关节疼痛。由于内收管(AC)中除SN外还包含支配膝关节内侧的其他感觉神经。我们比较了在膝关节内侧室骨关节炎(KOA-MC)中,在AC内和AC外的SN的PRF对疼痛缓解的质量和持续时间。方法:我们对60例由KOA-MC引起的膝前内侧疼痛患者进行了一项随机前瞻性研究。A组给予PRF-SN治疗,B组给予PRF-AC治疗。主要目的是通过视觉模拟量表(VAS)评分比较疼痛,以及通过西安大略省和麦克马斯特大学骨关节炎指数(WOMAC)和牛津膝关节评分(OKS)比较日常生活质量的变化。次要目的是比较药物量化量表(MQS)和阻滞相关并发症的镇痛需求。组内比较采用方差分析(ANOVA)。组间正态分布资料采用学生t检验,非正态分布和有序资料采用Mann-Whitney u检验,分类资料采用卡方检验。p值< 0.05为显著性。结果:12周时Gr-B组VAS评分明显降低。与Gr-A相比,Gr-B在4、8、12和24周时的WOMAC评分和OXFORD评分显著降低。结论:PRF-AC比PRF-SN具有更好的疼痛缓解和功能预后,但疼痛缓解时间无显著差异。
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