scholarly journals Ultrasound-Guided Genicular Nerve Thermal Radiofrequency Ablation for Chronic Knee Pain

2016 ◽  
Vol 2016 ◽  
pp. 1-3 ◽  
Author(s):  
Joshua Wong ◽  
Nicholas Bremer ◽  
Paul D. Weyker ◽  
Christopher A. J. Webb
Keyword(s):  
Radiofrequency Ablation ◽  
Pain Relief ◽  
Lifestyle Modification ◽  
The United States ◽  
Ultrasound Guided ◽  
Nerve Blocks ◽  
Management Interventions ◽  
Chronic Knee Pain ◽  
Significant Pain ◽  
Pharmacologic Management

Osteoarthritis (OA) of the knee is one of the most common joint diseases affecting adults in the United States. For elderly patients with multiple medical comorbidities who do not wish to undergo total knee arthroplasty (TKA), lifestyle modification, pharmacologic management, and injections are the mainstay of therapy. Previously, pain management interventions were limited to intra-articular joint injections and viscosupplementation with hyaluronic acid. Fluoroscopic-guided techniques for radiofrequency ablation (RFA) of the genicular nerves have been previously described and a recent cadaveric study suggests that ultrasound-guided genicular nerve blocks can be performed accurately. We performed an ultrasound-guided radiofrequency ablation of the genicular nerves in 88-year-old woman who had deferred surgical management given her age. Following successful ultrasound guided diagnostic genicular nerve blocks, she proceeded to RFA using the same ultrasound guided technique. The procedure resulted in significant pain relief and improvement in overall function for greater than 6 months. The use of ultrasound provides a relatively rapid and noninvasive method to directly visualize genicular nerves and surrounding vasculature. Our case suggests that, for genicular nerve blockade and RFA, ultrasound may be a useful alternative to fluoroscopy. Not only did the procedure result in significant pain relief that has persisted for greater than 6 months but also more importantly her function status and quality of life were improved.

scholarly journals The Long Term Effectiveness of Genicular Nerve Blocks for Chronic Knee Pain: A Retrospective Study

2018 ◽  
pp. 75-77
Author(s):  
Laura Anne Lynem
Keyword(s):  
Retrospective Study ◽  
Radiofrequency Ablation ◽  
Pain Relief ◽  
Knee Pain ◽  
Nerve Block ◽  
Nerve Blocks ◽  
Chronic Knee Pain ◽  
Post Procedure

Chronic knee pain is a leading cause of chronic disability and its symptoms have a profound impact on the lives of those suffering from it. Current treatment modalities for chronic knee pain include pharmacologic and nonpharmacologic interventions. Genicular nerve blocks are a new therapeutic alternative that have been shown to relieve chronic knee pain and may provide significant relief in patients who are either poor surgical candidates or are unwilling to accept the risks associated with surgery. Genicular nerve blocks may provide long term pain relief for chronic knee pain and radiofrequency ablation (RFA) may not be necessary. This Institutional Review Board (IRB) approved retrospective study conducted at a single center university hospital involved 44 patients aged 43 to 87 who received genicular nerve blocks for chronic knee pain. The primary purpose of this study was to determine if genicular nerve blocks provide effective long term pain relief for patients with chronic knee pain. The numeric rating scale was used to measure the patient’s knee pain at baseline, 30, 90, and 120 days post procedure. Patients experienced a mean pain level of 7.43 out of 10 before the genicular nerve block and 4.02 afterward representing an average improvement of 42.6% in pain relief overall post procedure follow-up. A t-test revealed a statistically significant difference between the mean pain score before and after the blocks (t = 8.534, P < 0.01). Overall, the patients experienced significant pain relief of an average of 111.9 days resulting in an average of 42.6 percent pain relief post procedure follow-up. Out of the 44 patients, 15 (34.1%) underwent a RFA after receiving a genicular nerve block procedure to further manage their chronic knee pain symptoms. In conclusion, we have found statistically significant evidence that genicular nerve blocks provide effective long-term pain relief for patients with chronic knee pain. Therefore, for patients who are not surgical candidates, genicular nerve blocks represent a viable alternative treatment for knee pain. Key words: Genicular nerve blocks, chronic knee pain, genicular nerves, genicular nerve radiofrequency ablation

Evaluating predictors of pain reduction after genicular nerve radiofrequency ablation for chronic knee pain

2021 ◽  
Author(s):  
Annie Philip ◽  
Mark Williams ◽  
Jenae Davis ◽  
Avinash Beeram ◽  
Changyong Feng ◽  
...  
Keyword(s):  
Radiofrequency Ablation ◽  
Pain Relief ◽  
Knee Pain ◽  
Chart Review ◽  
Retrospective Chart Review ◽  
Pain Reduction ◽  
Nerve Blocks ◽  
Chronic Knee Pain ◽  
Pain Outcomes ◽  
Pain Improvement

Aim: Radiofrequency ablation (RFA) of genicular nerves can treat refractory chronic knee pain. This study evaluated association between patient and procedural characteristics and pain improvement after genicular nerve RFA. Materials & methods: A retrospective chart review. Data were extracted from patients who underwent thermal or cooled RFA of the knee. Results: A total of 124 patients were included. 81% of patients reported ≥75% pain relief after diagnostic nerve blocks. 35% reported ≥50% pain reduction from the RFA. Predictors of improved pain outcomes included higher baseline pain, no depression and thermal (vs cooled) RFA. Conclusion: Identifying patients who may benefit the most from genicular RFA is still not clear. Pain reduction differences between patients with and without depression and RFA type deserves further exploration.

Design of a Compliant Endoscopic Ultrasound-Guided Radiofrequency Ablation Probe

2016 ◽  
Author(s):  
Bradley W. Hanks ◽  
Mary Frecker ◽  
Matthew Moyer
Keyword(s):  
United States ◽  
Radiofrequency Ablation ◽  
The United States ◽  
Design Tools ◽  
Ablation Zone ◽  
Ultrasound Guided ◽  
Element Analysis ◽  
Common Cancer ◽  
Endoscopic Ablation ◽  
Endoscopic Radiofrequency Ablation

Pancreatic cancer is one of the most deadly forms of cancer in the United States. Due to its late diagnosis, only 20% of patients diagnosed with the disease are eligible for surgical resection which is considered the preferred method of treatment. Radiofrequency ablation is a common cancer treatment modality for patients ineligible for open surgery. There is a lack of ablation probes which may be used to generate spherical heating zones which closely match the geometry of typical tumors. In particular, there are no endoscopic ablation probes commercially available in the United States. In this paper the design of a compliant endoscopic radiofrequency ablation probe is presented. This probe features an array of compliant tines which deploy through the cancerous tissue to effectively broaden the ablation zone. A thermal ablation model is used to inform the design of the geometry of the probe. In addition, finite element analysis is used to determine the feasibility of the compliant structures. These design tools are used as aids to inform the design and direct modifications toward a feasible probe which generates a spherical ablation zone.

scholarly journals Successful Treatment of Genitofemoral Neuralgia Using Ultrasound Guided Injection: A Case Report and Short Review of Literature

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Harsha Shanthanna
Keyword(s):  
Case Report ◽  
Pain Relief ◽  
Groin Pain ◽  
Case Reports ◽  
Young Male ◽  
Short Review ◽  
Therapeutic Procedure ◽  
Ultrasound Guided ◽  
Nerve Blocks ◽  
Genitofemoral Nerve

A young male patient developed chronic, severe, and disabling right sided groin pain following resection of his left testicular cancer. Since there is considerable overlap, ultrasound guided, selective diagnostic nerve blocks were done for ilioinguinal, iliohypogastric, and genitofemoral nerves, to determine the involved nerve territory. It was revealed that genitofemoral neuralgia was the likely cause. As a therapeutic procedure, it was injected with local anesthetic and steroid using ultrasound guidance. The initial injection led to pain relief of 3 months. Subsequent blocks reinforced the existing analgesia and were sufficient to allow for maintenance with the use of analgesic medications. This case report describes the successful use of diagnostic selective nerve blocks for the assessment of groin pain, subsequent to which an ultrasound guided therapeutic injection of genitofemoral nerve led to long term pain relief. As a therapeutic procedure, genitofemoral nerve block is done in patients with genitofemoral neuralgia. Ultrasound allows for controlled administration and greatly enhances the technical ability to perform precise localization and injection. There are very few case reports of such a treatment in the published literature. Apart from the case report, we also highlight the relevant anatomy and a brief review of genitofemoral neuralgia and its treatment.

scholarly journals The Loss of Resistance Nerve Blocks

2011 ◽  
Vol 2011 ◽  
pp. 1-10 ◽  
Author(s):  
Shiv Kumar Singh ◽  
S. M. Gulyam Kuruba
Keyword(s):  
Pain Relief ◽  
Rectus Sheath ◽  
Developed Countries ◽  
Ultrasound Guided ◽  
Nerve Blocks ◽  
Post Operative Period ◽  
Anatomical Basis ◽  
Loss Of Resistance ◽  
Provide Pain Relief ◽  
The Developed Countries

Presently ultrasound guided nerve blocks are very fashionable but vast majority of people around the world cannot practice these techniques mostly due to lack of resources but even in the developed countries there is lack of training which precludes people from using it. Lack of resources does not mean that patient cannot be provided with appropriate pain relief using nerve blocks. There are some nerve blocks that can be done using the loss of resistance (LOR) techniques. These blocks like, tranversus abdominis plane (TAP), rectus sheath, ilio-inguinal and fascia iliaca blocks can be effectively utilized to provide pain relief in the peri-operative period. For these blocks to be effectively delivered it is essential to understand the anatomical basis. It is also important to understand the reasons for failure, which is mostly due to delivery of the local anaesthetic in the wrong plane. The technique for LOR is not only simple and effective but also it can be delivered with minimal resources. This article deals with the techniques used for LOR blocks, the relevant anatomy and the methods used to administer the blocks. The article also describes the various indications where these blocks can be utilized, especially in the post-operative period where the pain management is sub-optimal.

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