Cooled radiofrequency ablation provides extended clinical utility in the management of knee osteoarthritis: 12-month results from a prospective, multi-center, randomized, cross-over trial comparing cooled radiofrequency ablation to a single hyaluronic acid injection

Autor:	Ignacio Badiola, Douglas Beall, Keith Zora, Fred Khalouf, Michael DePalma, Jeffrey Lyman, Lynn Kohan, Antonia F. Chen, Eric Loudermilk, Matthew J. Pingree, Maged Guirguis
Jazyk:	angličtina
Rok vydání:	2020
Předmět:	Adult Male medicine.medical_specialty WOMAC lcsh:Diseases of the musculoskeletal system Knee Joint Sports medicine Osteoarthritis Injections Intra-Articular law.invention 03 medical and health sciences 0302 clinical medicine Rheumatology Randomized controlled trial Quality of life 030202 anesthesiology law medicine Humans Orthopedics and Sports Medicine Prospective Studies Hyaluronic Acid Aged Pain Measurement Aged 80 and over Cross-Over Studies business.industry Radiofrequency ablation Middle Aged Osteoarthritis Knee medicine.disease Crossover study Denervation United States Treatment Outcome Knee pain Non-surgical Cohort Quality of Life Physical therapy Female medicine.symptom lcsh:RC925-935 business 030217 neurology & neurosurgery Research Article
Zdroj:	BMC Musculoskeletal Disorders, Vol 21, Iss 1, Pp 1-11 (2020) BMC Musculoskeletal Disorders
ISSN:	1471-2474
Popis:	Background Safe and effective non-surgical treatments are an important part of the knee osteoarthritis (OA) treatment algorithm. Cooled radiofrequency ablation (CRFA) and hyaluronic acid (HA) injections are two commonly used modalities to manage symptoms associated with knee OA. Methods A prospective 1:1 randomized study was conducted in 177 patients comparing CRFA to HA injection with follow-ups at 1, 3, 6 and 12 months. HA subjects with unsatisfactory outcomes at 6-months were allowed to crossover and receive CRFA. Knee pain (numeric rating scale = NRS), WOMAC Index (pain, stiffness and physical function), overall quality of life (global perceived effect = GPE, EQ-5D-5 L), and adverse events were measured. Results At 12-months, 65.2% of subjects in the CRFA cohort reported ≥50% pain relief from baseline. Mean NRS pain score was 2.8 ± 2.4 at 12 months (baseline 6.9 ± 0.8). Subjects in the CRFA cohort saw a 46.2% improvement in total WOMAC score at the 12-month timepoint. 64.5% of subjects in the crossover cohort reported ≥50% pain relief from baseline, with a mean NRS pain score of 3.0 ± 2.4 at 12 months (baseline 7.0 ± 1.0). After receiving CRFA, subjects in the crossover cohort had a 27.5% improvement in total WOMAC score. All subjects receiving CRFA reported significant improvement in quality of life. There were no serious adverse events related to either procedure and overall adverse event profiles were similar. Conclusion A majority of subjects treated with CRFA demonstrated sustained knee pain relief for at least 12-months. Additionally, CRFA provided significant pain relief for HA subjects who crossed over 6 months after treatment. Trial registration This trial was registered on ClinicalTrials.gov, NCT03381248. Registered 27 December 2017
Databáze:	OpenAIRE
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