Sometimes, patients with painful knee osteoarthritis do not get sufficient pain relief with conservative treatments and do not want (or are not suitable candidates for) arthroplasty. Now, with the advent of genicular nerve radiofrequency ablation (GNRFA), such patients have another option.
As described in a recent issue of JBJS Essential Surgical Techniques, GNRFA has been shown to provide consistent pain relief for 3 to 6 months. Using heat generated from electricity delivered via fluoroscopically guided needle electrodes, the procedure denatures the proteins in the 3 genicular nerves responsible for transmitting knee pain. Although there is a paucity of high-quality studies on the efficacy of this procedure, one study found that, on average, GNRFA led to improvement of >60% from baseline knee pain for at least 6 months.
In the authors’ practice, GNFRA is generally not repeated if it is ineffective the first time, but the procedure has been shown to be safe when administered repeatedly in patients who respond well. Proper positioning of the electrodes is essential, but the authors caution that without ample experience, “it may be difficult to isolate the exact anatomic location of ≥1 of the genicular nerves.”
General anesthesia is not required for the procedure, which is commonly performed by interventional pain specialists. Despite theoretical concerns, no Charcot-type joints have been reported after GNRFA. The authors emphasize, however, that the procedure provides temporary relief at best; it does not eliminate the potential for nerve regrowth and does not alter the arthritic disease process. Even more importantly, GNRFA needs to be studied with higher-level clinical research designs, ideally an adequately powered sham/placebo-controlled randomized trial.
For more information about JBJS Essential Surgical Techniques, watch this video featuring JBJS Editor-in-Chief Dr. Marc Swiontkowski.
The Editors of The Journal of Bone & Joint Surgery (JBJS) are pleased to announce that JBJS Essential Surgical Techniques (EST) and JBJS Open Access (OA) are now archived in PubMed Central (PMC), the national repository of free full-text biomedical literature, and discoverable on PubMed.
Launched in 2011 and edited by Edward Cheng, MD, JBJS Essential Surgical Techniques offers readers an expanding online library of thoroughly vetted orthopaedic procedures, including high-quality instructional videos. Peer reviewed and derived from top-quality published clinical studies, EST articles and videos deliver detailed, practical surgical guidance to all orthopaedists—from seasoned practitioners to those just starting out in practice.
Launched in 2016, JBJS Open Access gives authors an open-access option bolstered by the outstanding service and editorial excellence that JBJS has delivered for more than 125 years. At the same time, orthopaedic clinicians and researchers worldwide benefit from all-inclusive access to the best clinical and basic-science content about musculoskeletal health and injury care. JBJS OA is co-edited by Eng Lee, MD, FRCSC and Robin Richards, MD, FRCSC.
To learn more about JBJS Essential Surgical Techniques, click here.
To learn more about JBJS Open Access, click here.
JBJS Essential Surgical Techniques (EST) is pleased to congratulate the winners of its two Editor’s Choice Awards for 2017:
The award for best surgical-technique article went to Morteza Kalhor, MD; Diego Collado, MD; Michael Leunig, MD; Paulo Rego, MD; and Reinhold Ganz, MD for Recommendations to Reduce Risk of Nerve Injury During Bernese Periacetabular Osteotomy (PAO).
The recipients of the best Key Procedures video award were Jorge Chahla, MD; Gilbert Moatshe, MD; Lars Engebretsen, MD, PhD; and Robert F. LaPrade, MD, PhD for Anatomic Double-Bundle Posterior Cruciate Ligament Reconstruction.
JBJS Essential Surgical Techniques (EST) and The Journal of Bone and Joint Surgery (JBJS) are pleased to announce two awards in the amount of $500 US each. One award will be for the best orthopaedic surgical technique article, and the other will be for the best Key Procedures (KP) video submitted in 2016.
Key criteria for a high-quality EST article include, but are not limited to:
- Clearly written step-by-step instructions (for EST papers) or a comprehensive storyboard (for KP video submissions)
- High-resolution, instructive video clips
- Clinical relevance of technique or procedure
Winning authors will be notified in February 2017. Their achievement will be recognized online as well as during the JBJS reception at the AAOS Annual Meeting in March 2017.
Questions regarding the contest and submission process can be sent to email@example.com.
The best of what the JBJS family of publications offers is at jbjs.org. That includes access to our online journals—JBJS Reviews, JBJS Case Connector, and JBJS Essential Surgical Techniques.
Whether you subscribe to the full suite of JBJS products or only the flagship Journal of Bone & Joint Surgery, activating your online subscription improves all-around access to the most authoritative orthopaedic information. It’s easy:
- Go to https://store.jbjs.org/activatecustomer.
- Enter your subscriber number (located on the mailing label of your printed JBJS issue).
- Create a password and complete the registration form. Be sure to indicate your subspecialty.
During the AAOS 2016 Annual Meeting, JBJS showcased new innovative features and resources, including Key Procedure Video Articles, demonstrating core orthopaedic procedures.
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