Percutaneous freezing of sensory nerves prior to total knee arthroplasty

被引:65
作者
Dasa, Vinod [1 ]
Lensing, Gabriel [2 ]
Parsons, Miles [2 ]
Harris, Justin [2 ]
Volaufova, Julia [3 ]
Bliss, Ryan [1 ]
机构
[1] LSUHSC Sch Med, Dept Orthopaed, New Orleans, LA 70112 USA
[2] LSUHSC Sch Med, 433 Bolivar St, New Orleans, LA 70112 USA
[3] LSUHSC Sch Publ Hlth, 2020 Gravier St,Off 255, New Orleans, LA 70112 USA
关键词
Total knee arthroplasty; Cryoneurolysis; Surgical outcomes; Pain control; Length of hospital stay; PAROXYSMAL TRIGEMINAL NEURALGIA; LENGTH; STAY;
D O I
10.1016/j.knee.2016.01.011
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
100224 [整形外科学];
摘要
Background: Total knee arthroplasty (TKA) is a common procedure resulting in significant post-operative pain. Percutaneous cryoneurolysis targeting the infrapatellar branch of the saphenous nerve and anterior femoral cutaneous nerve could relieve post-operative knee pain by temporarily blocking sensory nerve conduction. Methods: A retrospective chart review of 100 patients who underwent TKA was conducted to assess the value of adding perioperative cryoneurolysis to a multimodal pain management program. The treatment group consisted of the first 50 patients consecutively treated after the practice introduced perioperative (five days prior to surgery) cryoneurolysis as part of its standard pain management protocol. The control group consisted of the 50 patients treated before cryoneurolysis was introduced. Outcomes included hospital length of stay (LOS), post-operative opioid requirements, and patient-reported outcomes of pain and function. Results: A significantly lower proportion of patients in the treatment group had a LOS of >= 2 days compared with the control group (6% vs. 67%, p < 0.0001) and required 45% less opioids during the first 12 weeks after surgery. The treatment group reported a statistically significant reduction in symptoms at the six- and 12-week follow-up compared with the control group and within-group significant reductions in pain intensity and pain interference at two- and six-week follow-up, respectively. Conclusions: Perioperative cryoneurolysis in combination with multimodal pain management may significantly improve outcomes in patients undergoing TM. Promising results from this preliminary retrospective study warrant further investigation of this novel treatment in prospective, randomized trials. (C) 2016 The Authors. Published by Elsevier B.V.
引用
收藏
页码:523 / 528
页数:6
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