Knee replacement: Pulsed radiofrequency alternative 

Introduction

Chronic pain due to osteoarthritis of the knee is a widespread problem that can have a significant impact on quality of life. Total knee replacement has long been considered the ultimate solution for patients with severe osteoarthritis, requiring surgery under general anaesthetic to place the total knee prosthesis, replacing damaged joint surfaces. However, new, less invasive approaches, such as pulsed radiofrequency, are emerging as promising alternatives.

Pulsed Radiofrequency: Principles and Mechanisms of Action

Pulsed radiofrequency targets the nerves responsible for pain transmission, thus acting on knee pain. Unlike total knee replacement surgery, which involves an invasive procedure under general anaesthetic and requires a recovery period of around 15 days, RFP is a minimally invasive technique that disrupts pain signals without the need for major surgery.

Advantages of Pulsed Radiofrequency and Disadvantages of Knee Replacement

Advantages of Pulsed Radiofrequency :

1. Non-invasive : Unlike total knee replacement surgery, pulsed radiofrequency is a non-invasive technique that does not require major incisions or general anesthesia.
2. Selectivity RFP specifically targets the nerves responsible for pain transmission, offering targeted relief without affecting surrounding tissue.
3. Reversible The RFP is reversible, which means it can be adjusted or reversed if necessary, offering flexibility in the treatment of knee joint pain.
4. Less risk RFP reduces the risks associated with surgery, such as infections, excessive bleeding and post-operative complications.
5. No extended recovery period Unlike knee prosthesis, which requires a recovery period of around 15 days, RFP enables patients to return to their daily activities more quickly.

Disadvantages of knee replacement :

1. Surgical invasiveness : Total knee replacement is a major surgical procedure requiring general anaesthesia and the fitting of a total knee prosthesis.
2. Surgical risks Knee replacement surgery carries risks such as infection, blood clots, nerve damage and reactions to anesthesia.
3. Extended recovery period :After knee replacement surgery, patients generally undergo a period of rehabilitation and recovery that can last several weeks or even months.
4. Functional limitations Despite significant improvements, some activities may remain limited after knee replacement, particularly flexion and extension movements.
5. Wear and tear and limited service life : Knee prostheses can wear out over time, which may require subsequent revision surgery to replace them.

In comparison, pulsed radiofrequency offers a non-invasive, reversible alternative to knee prosthesis, with fewer risks and faster recovery. However, each option needs to be assessed individually according to the patient's needs and state of health.

Pulsed Radiofrequency procedures

PPN is generally performed on an outpatient basis, with light sedation if necessary. During the procedure, a pain medicine specialist guides a fine needle to the medial compartment or anterior part of the knee, where the nerves responsible for pain are located. Using minimally invasive technology, radiofrequency pulses are delivered, selectively disrupting pain signals.

Clinical Evidence of the Effectiveness of Pulsed Radiofrequency

Several studies have demonstrated the short- and long-term efficacy of RFP in the treatment of pain associated with osteoarthritis of the knee. Patients have reported significant relief of joint pain and improved functionality after the procedure. In addition, PBR offers long-lasting relief from chronic pain, making it an attractive option for patients suffering from knee osteoarthritis.