861 - Fluoroscopy Guided Intra-Articular Bipolar Pulsed Radiofrequency Stimulation for Postoperative Chronic Knee Pain: A Case Study

Case Diagnosis: Chronic postoperative knee pain is a challenging and distressing condition that can severely impact a patient's quality of life. Conventional treatments often provide limited relief, necessitating the exploration of novel and minimally invasive interventions.

Case Description: A 61-year-old female with a history of left patella open reduction and internal fixation (ORIF) due to a bomb blast injury 7 years ago. Postoperatively, her acute diffuse knee pain persisted as chronic pain that she rated as 10/10. Primary conservative management consisting of physiotherapy provided minimal pain relief. She responded to genicular nerve blockade and completed genicular nerve thermal radiofrequency ablation, which did not provide reduction of her pain. We performed intra-articular bipolar pulsed radiofrequency stimulation of the left knee. At 2 months follow up her pain intensity decreased from 8/10 to 6/10; then at the next 3 month follow up her pain intensity remained at 5/10.

Discussions: Chronic postoperative knee pain can arise from various sources, including nociceptive and neuropathic mechanisms. The targeted intra-articular bipolar pulsed radiofrequency stimulation directly addresses the affected joint, aiming to interrupt pain signaling and provide pain relief. The use of fluoroscopy ensures accurate electrode placement, optimizing the safety and effectiveness of the procedure.

This case report highlights the potential of fluoroscopy-guided intra-articular bipolar pulsed radiofrequency stimulation as an efficacious and safe intervention for managing chronic postoperative knee pain. However, it is essential to acknowledge the limited sample size and lack of a control group in this single-case study, warranting further research with larger clinical cohorts to validate the findings and assess long-term outcomes.

Conclusions: The application of fluoroscopy guided intra-articular bipolar pulsed radiofrequency stimulation of the knee joint can be an efficacious and minimally invasive intervention option for the management of chronic postoperative knee pain.