A new study suggests cooled radiofrequency ablation (C-RFA) offers long-term relief for chronic and debilitating pain after knee replacement surgery.

Researchers at Emory University (Atlanta, GA, USA) conducted a study involving 21 patients who experienced persistent and chronic pain following total knee replacement, without any underlying hardware complications; all of the patients had failed conservative care. For the study, the patients filled out clinically validated questionnaires to assess pain severity, stiffness, functional activities of daily living, and use of pain medication before and after the C-RFA procedure.

Follow-up outcome scores were collected up to one year after the procedure. The questionnaire results showed that the patients experienced, on average, a statistically significant improvement in quality of life, with both pain and stiffness scores improving dramatically. No major complications were seen, and no patients required repeat treatment, surgical revision, or other interventions. The study was presented at the annual meeting of the Radiological Society of North America (RSNA), held during November-December 2021 in Chicago (IL, USA).

“The procedure's long-term relief gives it a major advantage over cortisone injections, which offer on average only about three months of pain relief. It's very encouraging that up to a year out these patients have such significant pain relief and a better quality of life,” said lead author Felix Gonzalez, MD. “With a larger propagating heat wave, you can account for the differences in nerve anatomy from patient to patient because of a larger treatment zone; treating a larger zone increases the effectiveness of the procedure.”

The C-RFA procedure involves insertion of an introducer needle under local anesthesia that targets specific nerve locations around the knee. A probe is then guided through the introducers. The tip of the probe imparts low voltage RFA to the deep sensory nerves around the knee. Water circulating through the system allows for a greater dissipation of heat from the tip of the probe. 

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