The Korean Journal of Pain

The Korean Pain Society (대한통증학회)
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Alcohol neurolysis of genicular nerve for chronic knee pain

  • Dass, Rushin Maria (Department of Anaesthesia and Pain Medicine, Pusan National University School of Medicine) ;
  • Kim, Eunsoo (Department of Anaesthesia and Pain Medicine, Pusan National University School of Medicine) ;
  • Kim, Hae-kyu (Department of Anaesthesia and Pain Medicine, Pusan National University School of Medicine) ;
  • Lee, Ji Youn (Department of Anaesthesia and Pain Medicine, Pusan National University School of Medicine) ;
  • Lee, Hyun Ju (Department of Anaesthesia and Pain Medicine, Pusan National University School of Medicine) ;
  • Rhee, Seung Joon (Department of Orthopaedic Surgery, Pusan National University Hospital)
  • Received : 2019.01.14
  • Accepted : 2019.04.01
  • Published : 2019.07.01
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Abstract

Radiofrequency neurolysis (RFN) of the genicular nerves has recently become accepted as an effective technique to alleviate knee pain particularly in patients with knee osteoarthritis (OA) or postoperative pain. However, genicular nerve RFN can produce high procedure and equipment costs, longer procedural times, procedure-related pain, and failure rate of over 25%. We are presenting two cases of alcohol neurolysis of the genicular nerve using fluoroscopy and ultrasonography in patients with knee OA or persistent postsurgical pain of the knee. Alcohol neurolysis of the genicular nerve with dual imaging modality can be a cheap, safe and effective method in patients with chronic knee pain.

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References

  1. Mantyselka P, Kumpusalo E, Ahonen R, Kumpusalo A, Kauhanen J, Viinamaki H, et al. Pain as a reason to visit the doctor: a study in Finnish primary health care. Pain 2001; 89: 175-80. https://doi.org/10.1016/S0304-3959(00)00361-4
  2. Wylde V, Hewlett S, Learmonth ID, Dieppe P. Persistent pain after joint replacement: prevalence, sensory qualities, and postoperative determinants. Pain 2011; 152: 566-72. https://doi.org/10.1016/j.pain.2010.11.023
  3. Peat G, McCarney R, Croft P. Knee pain and osteoarthritis in older adults: a review of community burden and current use of primary health care. Ann Rheum Dis 2001; 60: 91-7. https://doi.org/10.1136/ard.60.2.91
  4. 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: 41-52.
  5. 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: 169-77.
  6. Mata J, Valenti P, Hernandez B, Mir B, Aguilar JL. Study protocol for a randomised controlled trial of ultrasoundguided pulsed radiofrequency of the genicular nerves in the treatment of patients with osteoarthritis knee pain. BMJ Open 2017; 7: e016377. https://doi.org/10.1136/bmjopen-2017-016377
  7. 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: 481-7. https://doi.org/10.1016/j.pain.2010.09.029
  8. 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: E437-44. https://doi.org/10.36076/ppj.2017.E444
  9. Lee SJ, Park SC, Baek S, Yoon CS, Lee JH. Pulsed radiofrequency lesioning of the saphenous nerve in degenerative osteoarthritis of knee - a case report. Korean J Pain 2003; 16: 212-6.
  10. Walega DR, McCormick ZL. Chemical neurolysis of the genicular nerves for chronic knee pain: reviving an old dog and an old trick. Pain Med 2018; 19: 1882-4. https://doi.org/10.1093/pm/pny023
  11. Ahmed A, Arora D. Ultrasound-guided neurolysis of six genicular nerves for intractable pain from knee osteoarthritis: a case series. Pain Pract 2019; 19: 16-26. https://doi.org/10.1111/papr.12710
  12. 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: 407-14. https://doi.org/10.1097/AAP.0000000000000778
  13. SariS, Aydin ON, Turan Y, Sen S, Ozlulerden P, Omurlu IK, et al. Which imaging method should be used for genicular nerve radio frequency thermocoagulation in chronic knee osteoarthritis? J Clin Monit Comput 2017; 31: 797-803. https://doi.org/10.1007/s10877-016-9886-9
  14. Kesikburun S, Yasar E, Uran A, Adiguzel E, Yilmaz B. Ultrasound-guided genicular nerve pulsed radiofrequency treatment for painful knee osteoarthritis: a preliminary report. Pain Physician 2016; 19: E751-9.
  15. DemIr Y, Guzelkucuk U, Tezel K, AydemIr K, Taskaynatan MA. A different approach to the management of osteoarthritis in the knee: ultrasound guided genicular nerve block. Pain Med 2017; 18: 181-3. https://doi.org/10.1093/pm/pnw177
  16. Hirasawa Y, Okajima S, Ohta M, Tokioka T. Nerve distribution to the human knee joint: a natomical and immunohistochemical study. Int Orthop 2000; 24: 1-4. https://doi.org/10.1007/s002640050001
  17. Roos EM, Lohmander LS. The Knee injury and Osteoarthritis Outcome Score (KOOS): from joint injury to osteoarthritis. Health Qual Life Outcomes 2003; 1: 64. https://doi.org/10.1186/1477-7525-1-64

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