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Intra-articular Pulsed Radiofrequency Neuromodulation Versus Intra-articular Steroids for Painful Knee Osteoarthritis

Not Applicable
Completed
Conditions
Knee Osteoarthritis
Registration Number
NCT04238598
Lead Sponsor
Center For Interventional Pain and Spine
Brief Summary

To compare the efficacy of intra-articular pulsed radiofrequency to intra-articular steroids in patients with moderate-severe painful osteoarthritis of the knee.

Detailed Description

Patients Adult patients with intractable knee pain for more than 6 months and radiographic evidence of grade II, III or IV knee osteoarthritis. Must not have had a knee injection or other interventional procedure for knee pain within the past 12 weeks. Must be on stable medications for the past 12 weeks and willing to keep medications stable for the first 12 weeks of the study.

Study Design Pilot study will enroll 30 patients randomized 1:1:1.

1. Active control - intra-articular 4 milliliters 0.5% bupivacaine + 10mg dexamethasone + sham Pulsed Radiofrequency

2. Placebo control - intra-articular 5 milliliters 0.9% saline + sham Pulsed Radiofrequency

3. Treatment group - intra-articular 5 milliliters 0.5% bupivacaine + Pulsed Radiofrequency

Methods Two 18-gauge radiofrequency needle with 10 millimeter active tip will be placed intra-articularly from an anterolateral and anteromedial approach to target the medial and lateral compartments. Once satisfactory fluoroscopic placement is noted, the Pulsed Radiofrequency or sham-Pulsed Radiofrequency treatment will be administered. Subsequently, the injectate will be administered. Dexamethasone is selected as the corticosteroid as it is colorless and will be indistinguishable from the saline used in the Intra-articular Pulsed Radiofrequency and placebo groups.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
30
Inclusion Criteria
  • Capable of giving written informed consent
  • Patients aged 18 years or older
  • Patients with unilateral or bilateral knee pain for at least 3 months
  • Radiographic evidence of knee osteoarthritis
  • Appropriate candidate for steroid injection as determined by the investigator
Exclusion Criteria
  • Chronic knee pain caused by infection, inflammation, tumors, and fractures
  • A history of acute knee pain, previous knee surgery, connective tissue diseases, progressive neurologic disease or uncontrolled psychiatric disorders
  • The administration of steroids or hyaluronic acids within the last three months
  • Coagulation disorders
  • Local infection at the site of intervention planned
  • Active litigation related to this pain complaint

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Primary Outcome Measures
NameTimeMethod
Change in Visual Analogue Scale pain scores1-week, 1-, 3-, 6-, and 12-months

Evaluates the level of pain. Minimum=0 Maximum=10, Larger number indicates worse outcome

Secondary Outcome Measures
NameTimeMethod
Change in Analgesic use1-week, 1-, 3-, 6-, and 12-months

Evaluates number of medications, doses of medications

Change in Timed Up and Go Test1-week, 1-, 3-, 6-, and 12-months

Evaluates physical mobility

Change in Progression to Surgery1-week, 1-, 3-, 6-, and 12-months

Evaluates effectiveness of treatment

Change in Patient-Reported Outcomes Measurement Information System-29 and Western Ontario and McMaster Universities Osteoarthritis (Index)1-week, 1-, 3-, 6-, and 12-months

Evaluates level of pain. For Patient-Reported Outcomes Measurement Information System-29, Minimum= 8 and Maximum=40. For Western Ontario and McMaster Universities Osteoarthritis (Index), Minimum=0 Maximum=20. Larger number indicates worse outcome

Trial Locations

Locations (1)

Center for Interventional Pain and Spine

🇺🇸

Exton, Pennsylvania, United States

Center for Interventional Pain and Spine
🇺🇸Exton, Pennsylvania, United States

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