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Cooled radiofrequency ablation better than steroids for knee osteoarthritis

07 Nov 2017

Compared with injection of intra-articular steroids (IAS), cooled radiofrequency ablation (CRFA) is more effective at long-term pain management and physical function improvement for painful knee osteoarthritis (OA), a new study suggests.

The prospective randomized trial included 151 chronic knee pain patients who were unresponsive to conventional, conservative treatment approaches, and who were randomized in a 1:1 ratio to receive either IAS (n=75; mean age at consent 66±13 years) or CRFA (n=76; mean age at consent 63±12 years). Follow-up visits were at 1, 3 and 6 months postintervention.

The research team compared the primary efficacy endpoint, defined as the proportion of patients with at least 50-percent reduction in knee pain from baseline, between the two treatment groups. Analgesic use, knee function and adverse events (AEs) were included as secondary endpoints.

While baseline pain scores for the CRFA (7.3±1.2) and IAS (7.2±1) groups were not significantly different from each other, scores for the CRFA group were significantly lower at 1 (3±2.3 v 3.9±2.2; p=0.025), 3 (2.8±2.2 v 5.2±2; p<0.0001) and 6 (2.5±2.3 vs 5.9±2.2; p<0.0001) months. Reduction in pain scores were significant for both groups (p<0.0001 at each time point) relative to baseline.

Moreover, a significantly larger proportion of the CRFA group met the criteria for a successful outcome at 6 months compared with the IAS group (74 v 16 percent; p<0.0001). In contrast, there were more nonresponders in the IAS than CRFA group (83.8 vs 25.9 percent).

“[T]he findings of this study indicate that CRFA for genicular nerve ablation is superior to a single corticosteroid injection in [OA patients] for managing knee pain,” said the researchers.

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Most Read Articles
Yesterday
In obese Chinese type 2 diabetes (T2D) patients, hedonic hunger is significantly inversely correlated with good glycaemic control, a recent study shows. This relationship was absent in their nonobese counterparts.
Elvira Manzano, 16 Jan 2018
Cancer patients at risk for recurrent venous thromboembolism (VTE) are less likely to experience recurrence with rivaroxaban compared with dalteparin, the Select-D trial has shown, ushering in a new standard of care (SoC) for cancer-related VTE.
3 days ago
Rates of immunization particularly in a primary care setting can be improved by constant patient reminders and recall systems, a recent study has found.
4 days ago
It appears that urgent repeat endoscopic retrograde cholangiopancreatography (ERCP) predicts failure of plastic stent treatment for biliary strictures (BS) following liver transplant, according to a study.