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Clinical Research Article

Korean J Pain 2022; 35(4): 447-457

Published online October 1, 2022 https://doi.org/10.3344/kjp.2022.35.4.447

Copyright © The Korean Pain Society.

Predictive factors associated with successful response to utrasound guided genicular radiofrequency ablation

Selin Guven Kose1 , Halil Cihan Kose2 , Feyza Celikel3 , Omer Taylan Akkaya2

1Department of Pain Medicine, Health Science University Gaziler Physical Therapy and Rehabilitation Training and Research Hospital, Ankara, Turkiye
2Department of Pain Medicine, Health Science University Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkiye
3Department of Physical Therapy and Rehabilitation, Health Science University Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkiye

Correspondence to:Selin Guven Kose
Department of Pain Medicine, Health Science University Gaziler Physical Therapy and Rehabilitation Training and Research Hospital, Universiteler Mahallesi, Lodumlu Yolu, 29 Ekim Sokak, No:1, Bilkent, Cankaya, Ankara 06800, Turkiye
Tel: +905358419952
Fax: +903122911009
E-mail: selinguven89@gmail.com

Handling Editor: Jin Woo Shin

Author contributions: Selin Guven Kose: Resources; Halil Cihan Kose: Writing/manuscript preparation; Feyza Celikel: Writing/manuscript preparation; Omer Taylan Akkaya: Supervision.

Received: March 18, 2022; Revised: May 26, 2022; Accepted: June 16, 2022

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background: Ultrasound-guided genicular nerve radiofrequency (RF) procedures are of interest in the management of chronic knee pain. A wide variety of demographic, clinical, and procedural characteristics can affect treatment success. This study aimed to determine predictive factors to provide superior treatment outcomes.
Methods: The demographic, clinical, and technical data of patients who received genicular nerve RF for knee pain between September 2016 and September 2021 were evaluated. A positive outcome was defined as at least 50% pain relief on a pain score for at least 6 months. Logistic regression analysis was performed to determine the factors associated with a successful response to genicular RF.
Results: Among 206 patients who underwent genicular RF, 62% of the patients reported successful outcomes at 6 months. In the multivariate model, targeting 5 nerves (odds ratio [OR], 6.184; 95% confidence interval [CI], 2.291–16.690; P < 0.001) was the most significant predictor of successful outcomes. Multivariable logistic regression analysis showed that prognostic genicular nerve block with a 50% cut-off value (OR, 2.109; 95% CI, 1.038–4.287; P = 0.039), no opioid use (OR, 2.753; 95% CI, 1.405–5.393; P = 0.003), and depression (OR, 0.297; 95% CI, 0.124–0.713; P = 0.007) were the predictive factors significantly associated with response to genicular RF.
Conclusions: Clinical and technical factors associated with better treatment outcomes were ultimately targeting more nerves, performing prognostic block, no opioid use, and no depression. These results are expected to be considered when selecting patients for genicular RF.

Keywords: Chronic Pain, Knee, Nerve Block, Outcome Assessment, Health Care, Pain, Prognosis, Radiofrequency Ablation, Treatment Outcome, Ultrasonography, Interventional.