Article referred in press describes how radiofrequency to 3/5 of Genicular nerves could induce over 50% improvement in 59% of cases over the 3 months followup.
Commentary
A new target for radiofrequency neurotomy?
Gunnvald Kvarstein
Pain 2010 in press
- 19 radiofrequency; 19 controls
- 3 month followup
- offered to subjects that got > 50% relief from a single test block of nerves
- used a big 10 mm probe which author thought would generate larger lesions
- used a 2 Hz nerve probe to avoid hitting and muscle nerves
- one patient fell in bathroom several weeks later and although they couldn’t prove it, there was a concern nerve ablation might affect joint stability though no muscle weakness was detected.
- One subject got a hemarthrosis (blood in joint) some time later
- 59% got >50% relief versus none of controls
- Considered a possibility for patients too sick to have surgery (eg – heart-wise “cardiovascular”)
Comment – could same approach be accomplished with semi-neurolytic local (pontocaine or 5% lidocaine) or with cryotherapy? Many years ago, for one frail elderly lady, I injected 5% lidocaine combined with lidocaine base (had to be heated just prior to dissolve) near the saphenous nerve of an affected OA knee. This gave relief for up to 6 month but was associated with a painless limp so was abandoned. Maybe someone will find a way to do more distal application…
Actual article, that commentary discusses, is not yet available online so I do not have specifics on radiofrequency technique.