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The Effect of RF Genicular Nerve Block Applied in the Preoperative Period on Fast-track Total Knee Arthroplasty

Recruiting
Conditions
Knee Osteoarthritis
Knee Pain Chronic
Interventions
Procedure: Genicular nerve Radiofrequency Ablation block
Registration Number
NCT06239649
Lead Sponsor
Pamukkale University
Brief Summary

In our study, investigators plan to compare the preoperative RF and genicular nerve ablation approach in patients who underwent TKA(Total Knee Arthroplasty) using the Fast-Track protocol in terms of meeting postoperative pain, function and early discharge criteria.

Detailed Description

One of the most important components of surgery using Fast-Track is the application of effective and well-monitored pain treatment. Post-surgical pain negatively affects the patient's early mobilization. Reduction in pain after TKA(Total Knee Arthroplasty) may not only increase short-term functional results but also increase the patient's overall satisfaction.

Genicular Nerve Radiofrequency Ablation (GNRFA) is a non-surgical treatment increasingly used in patients with advanced knee osteoarthritis. Previous studies have shown this to be an effective and safe method to reduce pain and improve functionality in this patient population.

Neurolysis of genicular nerves with radiofrequency (RF) may be useful to relieve pain and improve both function and quality of life in patients with post-TKA pain.

Investigators thought that reducing the pain of patients who underwent TKA with Fast-track in the postoperative period would contribute to early mobilization and therefore rapid functional recovery. As a result of previous studies, investigators know that genicular nerve neurolysis with RF Ablation in the preoperative period provides a reduction in postoperative pain.

Investigators routinely apply TKA applications in clinic with Fast-Track. In investigators hospital's algology outpatient clinic, genicular nerve RF ablation is routinely performed under USG or fluoroscopy guidance. In investigators study, investigators plan to compare the preoperative RF and genicular nerve ablation approach in patients who underwent TKA using the Fast-Track protocol in terms of meeting postoperative pain, function and early discharge criteria

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
60
Inclusion Criteria
  • Being between the ages of 40 and 85,
  • Being able to understand verbal and written information given in Turkish,
  • Being able to speak and understand Turkish,
  • Being subjected to unilateral TKA surgery due to the diagnosis of Primary Knee osteoarthritis
Exclusion Criteria
  • Patients planned for revision knee prosthesis surgery,
  • Patients previously diagnosed with psychiatric disorders,
  • Patients who have undergone major surgery on the extremity where TKA will be applied,
  • Patients with comorbid diseases such as rheumatoid arthritis or cancer,
  • Patients with a score above 3 according to the American Society of Anesthesiologists (ASA) scoring,
  • Patients with neurological diseases that cause functional disability,
  • Patients with flexion limitation of more than 45 degrees and extension limitation of more than 20 degrees,
  • Patients who have to use hypnotic or anxiolytic drugs regularly,
  • Patients with alcohol or drug addiction,
  • Patients with bleeding disorders
  • Patients with uncontrolled diabetes

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
TKA with radiofrequency ablation genicular nerve blockGenicular nerve Radiofrequency Ablation blockTKA with radiofrequency ablation genicular nerve block
Primary Outcome Measures
NameTimeMethod
Knee Range of Motion preoperativeBaseline (preoperatively)

Digital goniometer used to assess knee range of motion

Performance-based activity limitations-preoperative 2at postoperative twelfth week

30-sec chair-stand test and stair-climb test are used

Pain preoperativeBaseline (preoperatively)

Visual Analog Scale used to assess pain

Knee Range of Motion postoperative 2at postoperative twelfth week

Digital goniometer used to assess knee range of motion

Quadriceps muscle strength postoperative 2at postoperative twelfth week

Quadriceps muscle strength is measured (unit=newton(N)) with hand-held dynamometer

Quality of life-preoperative 2at postoperative twelfth week

Short Form-36 (SF-36) is used

Length of hospital staythrough study completion, an average of 1 year

Length of hospital stay is measured beginning from the hospitalization of the patient and ending at discharge of the patients (unit-hours)

Knee Range of Motion postoperative 1at postoperative sixth week

Digital goniometer used to assess knee range of motion

Quadriceps muscle strength postoperative 1at postoperative sixth weeks

Quadriceps muscle strength is measured (unit=newton(N)) with hand-held dynamometer

Patient-reported activity limitations preoperative 2at postoperative twelfth week

The Western Ontario and McMaster Universities Arthritis Index and Knee injury and Osteoarthritis Outcome Score are used

Performance-based activity limitations-preoperativeBaseline (preoperatively)

30-sec chair-stand test and stair-climb test are used

Performance-based activity limitations-preoperative 1at postoperative sixth weeks

30-sec chair-stand test and stair-climb test are used

Quality of life-preoperativeBaseline (preoperatively)

Short Form-36 (SF-36) is used

Pain postoperative 1at postoperative sixth weeks

Visual Analog Scale used to assess pain

Pain postoperative 2at postoperative twelfth weeks

Visual Analog Scale used to assess pain

Quadriceps muscle strength preoperativeBaseline (preoperatively)

Quadriceps muscle strength is measured (unit=newton(N)) with hand-held dynamometer

Patient-reported activity limitations preoperativeBaseline (preoperatively)

The Western Ontario and McMaster Universities Arthritis Index and Knee injury and Osteoarthritis Outcome Score are used

Patient-reported activity limitations preoperative 1at postoperative sixth weeks

The Western Ontario and McMaster Universities Arthritis Index and Knee injury and Osteoarthritis Outcome Score are used

Quality of life-preoperative 1at postoperative sixth weeks

Short Form-36 (SF-36) is used

Secondary Outcome Measures
NameTimeMethod
Length of operation timethe surgery

Length of operation time is measured in minutes during the surgery

Amount of blood lossthrough study completion, an average of 1 year

Amount of blood loss is measured from the suction drainage (unit-milliliters)

postoperative component alignmentsthrough study completion, an average of 1 year

Long leg radiographs of the patients are evaluated postoperatively by using a digital orthopedic templating software-Materialise OrthoView (OrthoView version 7, Materialise HQ, Technologielaan 15 3001 Leuven, Belgium).

Trial Locations

Locations (1)

Pamukkale University

🇹🇷

Denizli, Pamukkale, Turkey

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