TY - JOUR
T1 - Comparison of cooled versus conventional radiofrequency treatment of the genicular nerves for chronic knee pain
T2 - a multicenter non-inferiority randomized pilot trial (COCOGEN trial)
AU - Vanneste, Thibaut
AU - Belba, Amy
AU - Kallewaard, Jan Willem
AU - van Kuijk, Sander M J
AU - Gelissen, Marloes
AU - Emans, Peter
AU - Bellemans, Johan
AU - Smeets, Kristof
AU - Terwiel, Chris
AU - Van Boxem, Koen
AU - Sommer, Micha
AU - Van Zundert, Jan
N1 - © American Society of Regional Anesthesia & Pain Medicine 2023. Re-use permitted under CC BY-NC. No commercial re-use. Published by BMJ.
PY - 2023/5
Y1 - 2023/5
N2 - BACKGROUND: Radiofrequency (RF) treatment of the genicular nerves has the potential to reduce chronic knee pain due to osteoarthritis or persistent postsurgical pain, however, a direct comparison between the two main modalities used, conventional and cooled, is lacking.METHODS: This double blind, non-inferiority, pilot, randomized controlled trial compared the effects of cooled and conventional RF in chronic knee pain patients suffering from osteoarthritis or persistent postsurgical pain after total knee arthroplasty. Patients were randomized following a 1:1 rate. The primary outcome was the proportion of patients with ≥50% pain reduction at 3 months postintervention. Other outcomes were knee pain, functionality, quality of life, emotional health, and adverse events up to 6 months postintervention. Conventional RF treatment was tested for non-inferiority to cooled in reducing knee pain at 3 months follow-up.RESULTS: Forty-nine of 70 patients were included, of which 47 completed a 3-month follow-up. The primary outcome was achieved in 4 of 23 patients treated with conventional RF (17%) vs in 8 of 24 with cooled (33%) (p=0,21). Results from the non-inferiority comparison were inconclusive in relation to the non-inferiority margin. There was no statistically significant difference between secondary outcomes. There were no serious adverse events.CONCLUSIONS: Both conventional and cooled RF treatment reduced pain in the osteoarthritis and persistent postsurgical pain population. This pilot study did not demonstrate statistically significant differences in the proportion of patients experiencing ≥50% pain reduction between techniques. The non-inferiority analysis was inconclusive. These results warrant further research.TRIAL REGISTRATION NUMBER: NCT03865849.
AB - BACKGROUND: Radiofrequency (RF) treatment of the genicular nerves has the potential to reduce chronic knee pain due to osteoarthritis or persistent postsurgical pain, however, a direct comparison between the two main modalities used, conventional and cooled, is lacking.METHODS: This double blind, non-inferiority, pilot, randomized controlled trial compared the effects of cooled and conventional RF in chronic knee pain patients suffering from osteoarthritis or persistent postsurgical pain after total knee arthroplasty. Patients were randomized following a 1:1 rate. The primary outcome was the proportion of patients with ≥50% pain reduction at 3 months postintervention. Other outcomes were knee pain, functionality, quality of life, emotional health, and adverse events up to 6 months postintervention. Conventional RF treatment was tested for non-inferiority to cooled in reducing knee pain at 3 months follow-up.RESULTS: Forty-nine of 70 patients were included, of which 47 completed a 3-month follow-up. The primary outcome was achieved in 4 of 23 patients treated with conventional RF (17%) vs in 8 of 24 with cooled (33%) (p=0,21). Results from the non-inferiority comparison were inconclusive in relation to the non-inferiority margin. There was no statistically significant difference between secondary outcomes. There were no serious adverse events.CONCLUSIONS: Both conventional and cooled RF treatment reduced pain in the osteoarthritis and persistent postsurgical pain population. This pilot study did not demonstrate statistically significant differences in the proportion of patients experiencing ≥50% pain reduction between techniques. The non-inferiority analysis was inconclusive. These results warrant further research.TRIAL REGISTRATION NUMBER: NCT03865849.
KW - Humans
KW - Osteoarthritis, Knee/complications
KW - Pain Management/methods
KW - Pain, Postoperative/diagnosis
KW - Pilot Projects
KW - Quality of Life
KW - Treatment Outcome
U2 - https://doi.org/10.1136/rapm-2022-104054
DO - https://doi.org/10.1136/rapm-2022-104054
M3 - Article
C2 - 36653065
SN - 1098-7339
VL - 48
SP - 197
EP - 204
JO - Regional anesthesia and pain medicine
JF - Regional anesthesia and pain medicine
IS - 5
ER -