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Chronic Knee Osteoarthritis: Intra - articular Sodium Hyaluronic Acid and Radiofrequency Neurotomy of Genicular Nerve

Avneesh Khare, Director and Consultant Pain Management, Khare Pain Clinic, Udaipur, Rajasthan 313002, India , Ashok Kumar B.K.1 , Avneesh Khare2 , Aditi Suri3 , Virendra Rastogi4

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Indian Journal of Anesthesia and Analgesia 5(11):p 1801-1805, November-December 2018. | DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.51118.4

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Abstract

  Background: Various modalities have been used for treatment of chronic knee osteoarthritis but with limited benefits. Radiofrequency neurotomy of genicular nerve is emerging as newer modality for pain relief with few complications. The present study was designed with an aim to compare combination of intra articular sodium hyaluronic acid and genicular radiofrequency neurotomy with intra articular sodium hyaluronic acid alone in chronic osteoarthritis patients. Methods: 40 patients of either sex, age 40­65 years suffering from knee pain due to advanced osteoarthritis with no benefit from conservative measures were randomly allocated into two groups. In Group A, intra articular sodium hyaluronic acid 6mL was injected under aseptic precautions. In Group B, intra articular sodium hyaluronic acid was followed by radio frequency neurotomy of genicular nerves. All patients were followed with pre­operative and post­ operative procedure outcome measurement at 1 week, 4 weeks, 12 weeks and 6 months. Results: Both groups were comparable with respect to age, height, weight, gender and BMI (Body Mass Index). Reduction in VAS (Visual Analogue Scale) and improvement in OKS (Oxford Knee Score) was better in Group B as compared to Group A at 1 week, 4 weeks, 12 weeks and 6 months post procedure, all differences being highly significant (p<0.001).

Conclusion: Combined therapy with intra articular sodium hyaluronic acid and genicular radiofrequency neurotomy is a safe, effective and minimally invasive procedure for knee osteoarthritis. It provides better pain relief and functional recovery of joints as compared to intra ­ articular sodium hyaluronic acid alone. 

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DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.51118.4

Keywords

Hyaluronic Acid; Radiofrequency; Genicular; Osteoarthritis; Knee.

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