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Application of cooled radiofrequency ablation in management of chronic joint pain
Affiliation:1. Anesthesiology Institute, Cleveland Clinic, Cleveland, Ohio;2. Department of Pain Management, Ochsner Health System, New Orleans, Louisiana;1. Department of Orthopaedic Surgery, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan;2. Department of Artificial Joints & Biomaterials, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan
Abstract:Radiofrequency ablation (RFA) is a minimally invasive neurotomy technique that can provide sensory ablation in patients with chronic pain. Cooled RFA, however, can create larger lesions compared with traditional RFA. Size of lesions plays a more important role in neurotomy of articular nerves where neural anatomy is not as predictable. We review the literature present about cooled radiofrequency neurotomy of articular branches of joints in patients with chronic pain of sacroiliac, hip, or knee joints. Sacroiliac joint pain is a significant etiology of low-back pain whereas low-back pain can be experienced by up to a third of the population. Chronic hip and knee pain can result in huge healthcare expenses as well as disability. The patients with chronic hip and knee pain might not be good candidates for arthroplasty surgeries because of their other comorbidities. Moreover, they might have persistent pain postoperatively. We also explain the technique used for neurotomy of articular branches in these joints.
Keywords:Joints pain  back pain  sacroiliac joint  knee joint  hip joint  neurotomy  radiofrequency ablation  cooled RFA
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