A review of the possible effects of radio frequency nerve ablation for knee osteoarthritis

• Main Author: Chan, Daniel
• Other Authors: Kumar, Deepak
• Language: en_US
• Published: 2021
• Subjects: Biomechanics; Knee; Osteoarthritis; Radio frequency ablation; RFA
• Online Access: https://hdl.handle.net/2144/43287

The knee is the most common site of osteoarthritis (OA) and is one of the leading causes of disability in older adults affecting over 53 million people in the United States and more than 302 million people worldwide. These numbers are only expected to grow because of the rise of diseases such as obesity, demographic shifts to an older population, and a more sedentary lifestyle. The rise of obesity and a more sedentary lifestyle comes with increases in joint loading which along with the aging population creates worse outcomes in proprioception. All of which can contribute to worsening OA. Despite the great costs to quality of life and society, there is no cure for OA. Only treatments exist to treat the symptoms of OA; and since knee pain is one of the most common symptoms of OA, it is a powerful driver for treatment because of the disruptive nature it can have on quality of life. Therefore, many treatments focus on pain relief and exercise to reduce the pain and worsening of OA. Radio frequency nerve ablation (RFA) is a procedure that is increasingly being performed for those who want an alternative before resorting to or are not a good match for total knee arthroplasty (TKA). Because RFA is minimally invasive, it can be performed on an outpatient basis and has been shown to be effective in reducing pain for at least 24 months for most patients. Despite the benefits in pain reduction, little is known about the biomechanical effects of RFA and its consequences on proprioception. However, based on prior studies into the pain relieving effects of interventions such as celecoxib or HA injections, we can hypothesize that with a decrease in pain, knee loading increases. Therefore, the pain relieving effects of RFA may increase the incidence of OA. Furthermore, because the RFA procedure involves ablating nerves that carry sensory information, changes to proprioception are expected. However, currently there is no information regarding its effect on proprioception. Again, using prior research that studies the consequences of reduced proprioception on those with OA, we can hypothesize that with RFA, proprioception would be further reduced compared to the reductions experienced by people with OA already, and it may also lead to worsening OA outcomes. Despite the possible issue of worsening OA outcomes with RFA, the pain relieving effects cannot be discounted as it is one of the most disruptive symptoms of OA. Therefore, effects of RFA on knee biomechanics and proprioception should be studied to understand the long-term impacts of this procedure.