Clinical trial NCT00924677: The Effect of Therapeutic Methods for Chronic Knee Osteoarthritis Pain
Official title: Phase 1 Study of Therapeutic Methods for Chronic Knee Osteoarthritis Pain
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Osteoarthritis, Knee
Keywords: genicular nerve
osteoarthritis
knee
neurotomy
Lead sponsor: Asan Medical Center
Sponsor class: OTHER
First posted: 2009-06-19
Enrollment: 38
Sex: ALL
Minimum age (years): 50
Maximum age (years): 80
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: Chronic osteoarthritis (OA) pain of the knee is not effectively abrogated by the available non-pharmacologic or pharmacologic treatments. Radiofrequency (RF) neurotomy is a therapeutic alternative for chronic pain. Here, the researchers investigate the efficacy of RF neurotomy applied to articular branches (genicular nerves) in treating knee joint pain.

Detailed description: The knee joint is innervated by articular branches of various nerves (femoral, common peroneal, saphenous, tibial and obturator) (Kennedy et al. 1982; Hirasawa et al. 2000). These articular branches around the knee joint are known as genicular nerves. Several genicular nerves can be easily approached percutaneously under fluoroscopic guidance. In our study, genicular nerves were effectively blocked with local anesthetics under fluoroscopic guidance, leading to a significant reduction in knee pain. Rf neurotomy is based on the theory that cutting the nerve supply to a painful structure may alleviate pain and restore function. we evaluate the efficacy of RF neurotomy in reducing pain and improving function in the elderly with chronic knee OA.

Eligibility criteria: Inclusion Criteria:

* patients with chronic knee pain (i.e., knee pain of moderate intensity or greater on most or all days for ≥ 3 months)
* patients with radiologic knee osteoarthritis (Kellgren-Lawrence grade 2-4, evaluated by a radiologist)

Exclusion Criteria:

* acute knee pain
* prior knee surgery
* other connective tissue diseases affecting the knee
* serious neurologic or psychiatric disorders
* injection with steroids or hyaluronic acids during the previous 3 months
* sciatic pain
* anticoagulant medications
* pacemakers
* prior electroacupuncture treatments

Primary outcomes:
measure: Visual analogue scale pain scores
timeFrame: at 12 weeks after the procedure
Secondary outcomes:
measure: Oxford knee score
timeFrame: at 12 weeks after the procedure
Other outcomes:
Locations:
city: Seoul
country: Korea, Republic of
facility: Asan Medical Center, University of Ulsan College of Medicine
Study officials:
affiliation: Asan Medical Center
name: Pyong-hwan Park, M.D.
role: STUDY_CHAIR
References:
citation: Kennedy JC, Alexander IJ, Hayes KC. Nerve supply of the human knee and its functional importance. Am J Sports Med. 1982 Nov-Dec;10(6):329-35. doi: 10.1177/036354658201000601.
citation: van Kleef M, Barendse GA, Kessels A, Voets HM, Weber WE, de Lange S. Randomized trial of radiofrequency lumbar facet denervation for chronic low back pain. Spine (Phila Pa 1976). 1999 Sep 15;24(18):1937-42. doi: 10.1097/00007632-199909150-00013.