Application Of Saphenous Nerve Radiofrequency Thermocoagulation In Treatment Of Knee Joint Pain

When frequency of electromagnetic wave that can radiates into space rises to over 10,000/s, the current is called high frequency current. Radio frequency (RF) is such high frequency current with AC variation frequency over 10,000 /s. In the current practice of clinical medicine where RF is used, RF apparatus emits over 10,000/s high frequency radio current. RF alternating current generates changing magnetic field at the working electrode tip, which makesions in target tissues in the magnetic field vibrate and build up frictional through their movement, particularly molecular motion of water molecules, and further damages target tissues or nerves by protein denaturation and coagulation. RF has been widely used in a number of medical fields. It can realize RF thermocoagulation treatment for intracranial lesion tissues with stereoscopic directional headstock, special microelectrode and computer operation software with the direction of C-arms or CT instruments so as to damage corresponding lesion tissues. It is also used in RF thermocoagulation treatment for lesion tissues in intervertebral disc with the aid of special electrodes, so as to damage the deseased intervertebral disc and relieve the compression on posterior branch of spinal nerve by protruding intervertebral disc, so that patients can be greatly relieved from their lumbus and leg pains RF radiofrequency thermocoagulation is also widely used in treatment of painful diseases by highly selectively damaging branches of pain sensory nerves and blocking transmission of pain signals towards ascending nerves so as to destroy pan pathways and preventing pain signals from being transmitted into brain and thus to control pain, particularly non-acute, long-lasting and intractable pains, e.g., radicular pain from spine, nerve source pain and post-surgery pain. In the current clinical practice, many pains that cannot be controlled by traditional treatment can be relieved effectively and even dissolved satisfactorily by damaging corresponding target tissues via RF radiofrequency thermocoagulation. Compared to traditional treatment by surgery, damage to the body of patients from RF radiofrequency thermocoagulation is far less. Owing thanks to micro-invasive surgery, it isfavored among patients against the shorter hospitalization period, rapid recovery and lower cost. Infrapateilarbranchesof saphenous nerves are distributed at the lower and inner side of knee and in front of patellar tendon. Saphenous nerve might suffer from entrapment in different parts during descending traveling. Saphenous nerve entrapment primarily presents as sore at the lower and inner side of knee, particularly significant tenderness at inner-side tibial intercondylar. Some young patients may suffer from knee pain, while knee pain is much more popular among the middle-aged and senior citizens, particularly female patients due to the effect of estrogen concentration. Mere intraarticular injection of sodium hyaluronate (SH) may not have ideal effect. Pain arising from saphenous nerve entrapment can be relived by effective treatment of saphenous nerve based on intraarticular injection of SH. The pain physician may lessen nerve entrapment and pain to improve clinical symptoms by blocking saphenous nerves, eliminating local inflammatory with medicines and softening fiber tissues. With progress and development of modern science and technology, RF radiofrequency thermocoagulation has been widely used in clinical practice, which also pushes treatment of saphenous nerve to a brand new stage. Intraarticular injection of sodium hyaluronate plus saphenous nerve block in treatment of kneeosteoarthritis and SH plus saphenous nerve RF in treatment and relieve of kneeosteoarthritis is observed herein. It intends to further study on therapy to relieve knee pain and providing data for Department of Pain to apply RF more effectively.This study is divided into two parts:Part 1 Intraarticular injection of sodium hyaluronate plus saphenous nerve RF in treatment and relieve of knee pai nObjective:To observe the effect of intraarticular injection of sodium hyaluronate plus saphenous nerve RF i n treatment of knee pai n.Approach:60 cases of knee osteoarthritis patients are divided into experiment group (Group H, n=30) and comparison group (Group C, n=30) randomly. The former is given SH plus saphenous nerve RF in treating and relieving their knee pain, while the latter is given intraarticular injection of sodium hyaluronate without effective RF treatment. WOMAC scores and SF-36 life quality scores (RF and VT) before treatment, in 5 mi,1 week,2 weeks and 4 weeks after treatment are eval uated. Complications during and after treatment are recorded.Result:The experiment group and the comparison group differ in their average changes in improvement of WOMAC pain, morning stiffness, function of body and SF-36 life quality score (RF and VT) with P<0.05. Such difference is of statistical significance.Conclusion:The effect of intraarticular injection of sodium hyaluronate plus saphenous nerve RF in treating knee pain is better than that of mere intraarticular injection of sodium hyal uronate.Part 2 Compari son on respecti ve effect of i ntraarti cul ar i nj ecti on of sodi um hyal uronate plus saphenous nerve block and intraarticular injecti on of sodium hyaluronate plus saphenous nerve RF in treating knee painObjective:To observe comparison on effect of intraarticular injection of sodium hyaluronate plus saphenous nerve block and saphenous nerve RF respectively in treating knee pan.Approach:50 cases of knee pain patients are divided into SH plus saphenous nerve block group (Group H, n=25) and SH plus saphenous nerve RF group (Group C, n=25. Group H is given intraarticular injection of sodium hyaluronate plus saphenous nerve block, while Group C is given intraarticular injection of sodium hyaluronate plus saphenous nerve RF. WOMAC scores and SF-36 life quality scores before treatment and in 1 week and 4 weeks after treatment are evaluated. Complications and negative responses during and after treatment are recorded.Result:The experiment group and the comparison group differ in their average changes in improvement of WOMAC pain, morning stiffness, function of body and SF-36 life quality score (RF and VT) with P<0.05. Such difference is of statistical significance.Conclusion:The effect of intraarticular injection of sodium hyaluronate plus saphenous nerve RF is better than that of intraarticular injection of sodium hyaluronate plus saphenous nerve block in treating knee pain.