Clinical and technical factors associated with knee radiofrequency ablation outcomes: A multicenter analysis

Yian Chen, To Nhu H. Vu, Vernon M. Chinchilli, Mohamed Farrag, Alexandra R. Roybal, Albert Huh, Zared O. Cohen, Adam B. Becker, Babak Arvanaghi, Mrinal Agrawal, Jacob Ogden, Steven P. Cohen

Research output: Contribution to journalArticlepeer-review

Abstract

Background There has been a surge in interest in radiofrequency ablation (RFA) of the genicular nerves over the past decade, with wide variability in selection, technique and outcomes. The aim of this study is to determine factors associated with treatment outcome. Methods We retrospectively evaluated the effect of 23 demographic, clinical and technical variables on outcomes in 265 patients who underwent genicular nerve RFA for knee pain at 2 civilian and 1 military hospital. A primary outcome was designated as a > 30% decrease in average knee pain score lasting at least 3 months without cointerventions. Results The overall rate of a positive response was 61.1% (95% CI 55.2% to 67.0%). In univariable analysis, larger electrode size (p=0.01), repeated lesions (p=0.02), having>80% pain relief during the prognostic block (p=0.02), not being on opioids (p=0.04), having no coexisting psychiatric condition (p=0.02), having a lower baseline pain score (p=0.01) and having >3 nerves targeted (p=0.02) were associated with a positive outcome. In multivariate logistic analysis, being obese (OR 3.68, 95% CI 1.66 to 8.19, p=0.001), not using opioids (OR 0.35, 95% CI 0.16 to 0.77, p=0.009), not being depressed (OR 0.29, 95% CI 0.10 to 0.82, p=0.02), use of cooled RFA (OR 3.88, 95% CI 1.63 to 9.23, p=0.002) and performing multiple lesions at each neural target (OR 15.88, 95% CI 4.24 to 59.50, p<0.001) were associated with positive outcome. Conclusions We identified multiple clinical and technical factors associated with treatment outcome, which should be considered when selecting patients for RFA treatment and in the design of clinical trials.

Original languageEnglish (US)
Pages (from-to)298-304
Number of pages7
JournalRegional anesthesia and pain medicine
Volume46
Issue number4
DOIs
StatePublished - Apr 1 2021

Keywords

  • chronic pain
  • diagnostic techniques and procedures
  • nerve block
  • pain management
  • treatment outcome

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

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