Fluoroscopic Versus Ultrasound Guidance for Cooled Radiofrequency Ablation of Geniculate Nerves in Knee Osteoarthritis: A Randomized Control Trial
Knee Osteoarthritis
About this trial
This is an interventional treatment trial for Knee Osteoarthritis
Eligibility Criteria
Inclusion Criteria:
- 1) patients of either gender with primary knee OA of one or both knees fulfilling the diagnostic criteria for knee OA by the American College of Rheumatology,
- 2) Kellgren-Lawrence score of two to four,
- 3) reported NPRS pain intensity of at least four on most or all days of the past week
- 4) pain resistant to conventional treatments which may include but is not limited to medications (e.g. acetaminophen, oral or topical non-steroidal anti-inflammatory drugs, opioids), physical therapy, and intra-articular injections (e.g. corticosteroids, hyaluronic acid, platelet-rich-plasma) for at least 3 months. In the case of bilateral knee OA, the most symptomatic knee will be treated and studied.
Exclusion Criteria:
- 1) age <35 years,
- 2) non-English speaking patients,
- 3) body mass index greater than 40,
- 4) previous radiofrequency ablation procedure for the knee,
- 5) active systemic or local infections at the site of needle/cRFA probe placement,
- 6) previous knee joint replacement surgery,
- 7) autoimmune or inflammatory cause of knee arthritis such as rheumatoid or psoriatic arthritis,
- 8) non-ambulatory patients,
- 9) patients who are unable to provide their own consent (e.g. dementia),
- 10) unstable medical or psychiatric illness,
- 11) patients with pacemakers, spinal cord stimulators, deep brain stimulators, or similar devices,
- 12) patients seeking care as a part of workman's compensation or have litigation pending
- 13) a negative response to diagnostic geniculate nerve lidocaine injections.
Sites / Locations
- UC Davis Health
- University of RochesterRecruiting
Arms of the Study
Arm 1
Arm 2
Experimental
Experimental
Subjects with knee OA using ultrasound for cRFA intervention
Subjects with knee OA using fluoroscopy for cRFA intervention
Knee osteoarthritis patients (Kellegren-Lawrence Scale 2-4) that have been refractory to conservative treatments and report at least 80% pain relief with diagnostic geniculate nerve blocks will be enrolled and randomized to ultrasound (N=45) cRFA treatment arm.
Knee osteoarthritis patients (Kellegren-Lawrence Scale 2-4) that have been refractory to conservative treatments and report at least 80% pain relief with diagnostic geniculate nerve blocks will be enrolled and randomized to fluoroscopic (N=45) cRFA treatment arm.