Radiofrequency For Chronic Knee Pain Post-Arthroplasty

NCT ID: NCT02931435

Last Updated: 2018-12-13

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

9 participants

Study Classification

INTERVENTIONAL

Study Start Date

2016-12-31

Study Completion Date

2018-11-30

Brief Summary

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Chronic knee osteoarthritis (OA) is one of the most common diseases with increasing prevalence in advanced age. Knee OA results in movement restriction, sleep disturbance, and disability. Total knee arthroplasty (TKA) is employed often in the symptomatic treatment of knee OA. It has been estimated that 3.4 million TKAs will be performed in the year 2030 in the United States alone. Many studies report rewarding outcomes for patients, but other research shows there are many patients that remain dissatisfied post-arthroplasty.

The purpose of this study is to evaluate whether genicular radiofrequency ablation can relieve chronic post-arthroplasty knee pain.

Detailed Description

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Chronic knee osteoarthritis (OA) is one of the most common diseases with increasing prevalence in advanced age. Knee OA results in movement restriction, sleep disturbance, and disability. Total knee arthroplasty (TKA) is employed often in the symptomatic treatment of knee OA. It has been estimated that 3.4 million TKAs will be performed in the year 2030 in the United States alone. Many studies report rewarding outcomes for patients, but other research shows there are many patients that remain dissatisfied post-arthroplasty.

As the prevalence of knee arthroplasty increases, so does the frequency of revisions. It has been found that 20% of patients reporting painful knee arthroplasties were not able to be diagnosed with a specific cause and were therefore referred to a pain specialist. Pharmacologic therapy and non-surgical interventions are often employed with minimal benefit to the patient's level of disability as indicated by clinical evidence.

Genicular radiofrequency ablation seems to be a safe, effective and minimally invasive therapy for chronic knee OA patients who have had a positive diagnostic block. No study has determined whether genicular radiofrequency ablation can relieve chronic post-arthroplasty knee pain. The investigators propose to examine the effect of genicular radiofrequency ablation in chronic post-arthroplasty knee pain in patients who respond positively to diagnostic nerve blocks.

Conditions

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Chronic Knee Pain Osteoarthritis, Knee

Keywords

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Genicular Radiofrequency Ablation Knee Arthroplasty, Total

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Participants Outcome Assessors

Study Groups

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Nerve Block with Radiofrequency Ablation

A 10 cm 18-gauge RF cannula with a 10 mm active tip will be placed at the superior lateral, superior medial, and inferior medial nerve positions under fluoroscopic guidance. Sensory stimulation at 50 Hz will be performed to identify nerve position and to assure no motor nerves will be ablated. Lidocaine (2 ml of 2%) will be administered in each location prior to RF generator activation.

Group Type ACTIVE_COMPARATOR

Nerve Block with Radiofrequency Ablation

Intervention Type PROCEDURE

Ablation of the genicular nerves of the knee by radiofrequency

Nerve Block with Sham Radiofrequency Ablation

A 10 cm 18-gauge RF cannula with a 10 mm active tip will be placed at the superior lateral, superior medial, and inferior medial nerve positions under fluoroscopic guidance.Control patients will undergo the same procedure without RF generator activation. Sensory stimulation at 50 Hz will be performed to identify nerve position and to assure no motor nerves will be ablated. Lidocaine (2 ml of 2%) will be administered in each location prior to RF generator sham activation.

Group Type SHAM_COMPARATOR

Nerve Block with Sham Radiofrequency Ablation

Intervention Type PROCEDURE

Genicular radiofrequency of the knee without neurotomy

Interventions

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Nerve Block with Radiofrequency Ablation

Ablation of the genicular nerves of the knee by radiofrequency

Intervention Type PROCEDURE

Nerve Block with Sham Radiofrequency Ablation

Genicular radiofrequency of the knee without neurotomy

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Study candidate must provide written informed consent.
* Must be ≥ 50 years of age at the time of consent
* Chronic knee pain despite total knee arthroplasty at least 6 months prior to consent
* Orthopedic evaluation indicating no further surgery is warranted
* Stable pain medication regimen for 30 days prior to baseline visit
* Knee pain is primary pain complaint

Exclusion Criteria

* Acute knee pain
* Connective tissue disorders affecting the knee
* Serious neurologic or psychiatric disorders that would affect the outcome of the study as determined by the Principal Investigator
* Steroid or hyaluronic acid injections into the affected knee in the past 3 months
* Confounding pain conditions of the index leg that may affect medication requirements or study outcomes
Minimum Eligible Age

50 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Abbott Medical Devices

INDUSTRY

Sponsor Role collaborator

Abbott

INDUSTRY

Sponsor Role collaborator

Randall Brewer, MD, CPI

OTHER

Sponsor Role lead

Responsible Party

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Randall Brewer, MD, CPI

Medical Director, Principal Investigator

Responsibility Role SPONSOR_INVESTIGATOR

Principal Investigators

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Randall Brewer, MD

Role: PRINCIPAL_INVESTIGATOR

WK River Cities Clinical Research Center

Locations

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WK River Cities Clinical Research Center

Shreveport, Louisiana, United States

Site Status

Countries

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United States

References

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Kurtz S, Ong K, Lau E, Mowat F, Halpern M. Projections of primary and revision hip and knee arthroplasty in the United States from 2005 to 2030. J Bone Joint Surg Am. 2007 Apr;89(4):780-5. doi: 10.2106/JBJS.F.00222.

Reference Type BACKGROUND
PMID: 17403800 (View on PubMed)

Nikolaou VS, Chytas D, Babis GC. Common controversies in total knee replacement surgery: Current evidence. World J Orthop. 2014 Sep 18;5(4):460-8. doi: 10.5312/wjo.v5.i4.460. eCollection 2014 Sep 18.

Reference Type BACKGROUND
PMID: 25232522 (View on PubMed)

Choi WJ, Hwang SJ, Song JG, Leem JG, Kang YU, Park PH, Shin JW. Radiofrequency treatment relieves chronic knee osteoarthritis pain: a double-blind randomized controlled trial. Pain. 2011 Mar;152(3):481-487. doi: 10.1016/j.pain.2010.09.029. Epub 2010 Nov 4.

Reference Type BACKGROUND
PMID: 21055873 (View on PubMed)

Al-Hadithy N, Rozati H, Sewell MD, Dodds AL, Brooks P, Chatoo M. Causes of a painful total knee arthroplasty. Are patients still receiving total knee arthroplasty for extrinsic pathologies? Int Orthop. 2012 Jun;36(6):1185-9. doi: 10.1007/s00264-011-1473-6. Epub 2012 Jan 11.

Reference Type BACKGROUND
PMID: 22234706 (View on PubMed)

Other Identifiers

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GENRF

Identifier Type: -

Identifier Source: org_study_id