Surgical Knee Denervation for the Treatment of Pain due to Primary Osteoarthritis
Benjamin F Watzig, MD1, Rachel Reichenbach, BS1, Dallin Merrell, BS2, Joey Robainia, MD1, Briana Silvestri, PA-C3 and Joshua W. Hustedt, MD, MHS4, 1University of Arizona-Phoenix College of Medicine, Phoenix, AZ, 2University of Arizona College of Medicine Phoenix, Phoenix, AZ, 3The University of Arizona College of Medicine – Phoenix, Phoenix, AZ, 4Orthopedics, University of Arizona-Phoenix College of Medicine, Phoenix, AZ
Introduction:
Denervation techniques have increased in popularity for treatment of primary knee osteoarthritis. However, few clinical trials have been conducted on surgical knee denervation. This study was conducted to evaluate the safety and efficacy of a surgical denervation technique for the treatment of primary knee osteoarthritis.
Materials & Methods:
Patients were included in the trial if they had failed conservative management for osteoarthritis with corticosteroid injections and were not candidates for total knee arthroplasty. Patients were treated with a surgical denervation approach with targeted muscle reinnervation. Pre- and post-operative scores were assessed to examine the improvement in pain, function, and quality of life. Complications were also tracked for the presence of peri-operative issues and postoperative infection or revision surgery.
Results:
Twenty-four knee denervation procedures were performed in twenty-one patients. The average follow-up time was 21 months. Patients experienced an improvement in pain with a decrease in VAS pain scores from 8.7 to 2.9, an improvement in function with a decrease in WOMAC scores from 69 to 32, and an improvement in quality of life with an increase in EQ-5D from 0.183 to 0.646. A clinically significant improvement in pain occurred in 92% patients, while 75% of patients had an improvement in function, and 83% an improvement in quality of life. No patients in the study experienced a postoperative complication or required a revision.
Conclusions:
The treatment of recalcitrant knee pain in non-arthroplasty candidates is a difficult issue. This trial suggests that a surgical denervation technique provides improvement in pain, function, and quality of life. Surgical denervation may be a beneficial treatment for patients with recalcitrant pain from primary knee osteoarthritis.
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