Ultrasound-guided Genicular Nerve Ablation with Alcohol Solution for Knee Osteoarthritis: A Case Series

Authors

  • John Butarbutar Department of Orthopedic, Siloam Hospital Lippo Village, Karawaci, Tangerang, Banten, Indonesia
  • Mirna Phandu Department of Orthopedic, Siloam Hospital Lippo Village, Karawaci, Tangerang, Banten, Indonesia
  • Kevin Lee Faculty of Medicine, Pelita Harapan University, Karawaci, Tangerang, Banten, Indonesia
  • Earlene Tasya Faculty of Medicine, Pelita Harapan University, Karawaci, Tangerang, Banten, Indonesia
  • Wendell Sebastian Sulaeman Faculty of Medicine, Pelita Harapan University, Karawaci, Tangerang, Banten, Indonesia

DOI:

https://doi.org/10.19166/med.v11i2.7531

Keywords:

Knee osteoarthritis treatment, Knee chemical ablation, Radiofrequency alternative

Abstract

Genicular nerve ablation using radiofrequency (RF) is a common minimally invasive procedure for painful osteoarthritic knees. However, the high cost and unavailability of equipment in many healthcare centers made this inconvenient for some patients. Some case reports tried the cheaper and newer method, using an alcohol solution to ablate the genicular nerves, showing considerable improvement in the patient's pain, functional knee score, and quality of life. We have attempted the ultrasound-guided genicular nerve ablation using alcohol solution in 6 patients with knee osteoarthritis to complement the body of evidence. We found that the genicular nerve ablation using alcohol solution is an excellent method for relieving symptoms of knee osteoarthritis if knee pain is the main symptom.

References

1. Dass RM, Kim E, Kim H, Lee JY, Lee HJ, Rhee SJ. Alcohol neurolysis of genicular nerve for chronic knee pain. The Korean Journal of Pain. 2019 Jul 1;32(3):223-7. https://doi.org/10.3344/kjp.2019.32.3.223

2. Ahmed A, Arora D. Ultrasound-Guided Neurolysis of Six Genicular Nerves for Intractable Pain from Knee Osteoarthritis: A Case Series. Pain Practice. 2018 Aug 8;19(1):16-26. https://doi.org/10.1111/papr.12710

3. Elashmawy MM, Shabana AAH, Elsaid TO, Elhawary GM. Ultrasound-guided genicular nerve block versus alcoholic neurolysis for treatment of advanced knee osteoarthritis patients. The Egyptian Rheumatologist. 2022 Oct;44(4):307-11. https://doi.org/10.1016/j.ejr.2022.04.002

4. El-Hakeim EH, Elawamy A, Kamel EZ, Goma SH, Gamal RM, Ghandour AM, et al. Fluoroscopic guided radiofrequency of genicular nerves for pain alleviation in chronic knee osteoarthritis: a single-blind randomized controlled trial. Pain Physician. 2018 Aug; 21(2): 169-77. http://dx.doi.org/10.36076/ppj.2018.2.169

5. Mata J, Valentí P, Hernández B, Mir B, Aguilar JL. Study protocol for a randomized controlled trial of ultrasound-guided pulsed radiofrequency of the genicular nerves in the treatment of patients with osteoarthritis knee pain. BMJ Open. 2017 Aug; 7(11): e016377. https://doi.org/10.1136/bmjopen-2017-016377

6. Choi WJ, Hwang SJ, Song JG, Leem JG, Kang YU, Park PH, et al. Radiofrequency treatment relieves chronic knee osteoarthritis pain: a double-blind randomized controlled trial. Pain. 2011 Jun; 152(3): 481-7. https://doi.org/10.1016/j.pain.2010.09.029

7. Iannaccone F, Dixon S, Kaufman A. A review of long-term pain relief after genicular nerve radiofrequency ablation in chronic knee osteoarthritis. Pain Physician 2016 Oct; 20(3):E437-44. http://dx.doi.org/10.36076/ppj.2017.E444

8. Walega D, McCormick D. Chemical Neurolysis of the Genicular Nerves for Chronic Knee Pain: Reviving an Old Dog and an Old Trick. Pain Medicine. 2018 ; 19(9):1882-1884. https://doi.org/10.1093/pm/pny023

Downloads

Published

2023-10-13

Issue

Vol. 13 No. 1 (2023): October

Section

Case Report

License

Authors who publish with this journal agree to the following terms:

1) Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License (CC-BY-SA 4.0) that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.

2) Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.

3) Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website). The final published PDF should be used and bibliographic details that credit the publication in this journal should be included.