Clinical trial: Diagnostic Genicular Nerve Block Prior to Radiofrequency Ablation for Knee Osteoarthritis Pain (NCT02578108)

Eligibility criteria:
Inclusion Criteria:

          1. All patients ages 30-80 with chronic painful knee osteoarthritis who would undergo
             treatment by genicular nerve radiofrequency ablation.

          2. Knee pain for at least 6 months.

          3. Kellgren-Lawrence knee osteoarthritis of 2 or greater.

          4. Pain resistant to conventional therapy including NSAIDs, opioids, muscle relaxants,
             oral steroids, physical therapy, and intra-articular injection therapy.

          5. No pain referral beyond the expected distribution for knee osteoarthritis.

        Exclusion Criteria:

          1. NRS pain score of 4 or more

          2. Focal neurologic signs or symptoms.

          3. Previous radiofrequency ablation treatment for similar symptoms.

          4. Intra-articular knee corticosteroid or hyaluronic acid injection in the past 3 months.

          5. Concomitant radicular pain.

          6. Previous knee surgery.

          7. Patient refusal.

          8. Lack of consent.

          9. Active systemic or local infections at the site of proposed needle and electrode
             placement.

         10. Coagulopathy or other bleeding disorder, current use of anticoagulants or
             anti-platelet medications.

         11. Allergy to medications being used for injection procedures (contrast, local
             anesthetic).

         12. Inability to read English, communicate with staff, or participate in follow-up.

         13. Pregnancy.

         14. Pacemaker.

         15. Cognitive deficit.

         16. Unstable medical or psychiatric illness.
No condition on gender to be admitted to the trial.
No healthy subjects accepted to join the trial.
Subject must be at least 30 Years old.
Subject must be at most 80 Years

Patient description (medical language): A 47-year-old woman comes to the office complaining of pain in the calf and knee when she bends down. The pain limits her activity. Her medical history is significant for osteoarthritis, for which she uses nonsteroidal anti-inflammatory drugs (NSAIDs) for the past two years. She is living with her husband and has 3 children. She doesn't smoke but drinks alcohol occasionally. Her vital signs are normal. On physical examination, there is a small effusion in the right knee. The effusion grew a little larger and she developed a tender swelling in the popliteal fossa and calf. Both the pain and swelling worsened as she bent and straightened her knee.

Patient description (patient's own words): I'm a 47-year-old woman, married with 3 kids. I don't smoke and I drink occasionally. I went to the doctor because of pain in my calf and knee when I was bending down. This has been limiting my daily activities. I have been diagnosed with osteoarthritis for which I have taken anti-inflammatory drugs for the past 2 years. The doctor saw a small fluid buildup in my right knee. This buildup became a bit bigger and I have a swollen calf. The pain is worse when I bend and straighten my knee.

Does the patient match the trial criteria? Entailment