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In our study, investigators plan to compare the preoperative RF and genicular nerve ablation approach in patients who underwent TKA(Total Knee Arthroplasty) using the Fast-Track protocol in terms of meeting postoperative pain, function and early discharge criteria.
One of the most important components of surgery using Fast-Track is the application of effective and well-monitored pain treatment. Post-surgical pain negatively affects the patient's early mobilization. Reduction in pain after TKA(Total Knee Arthroplasty) may not only increase short-term functional results but also increase the patient's overall satisfaction.
Genicular Nerve Radiofrequency Ablation (GNRFA) is a non-surgical treatment increasingly used in patients with advanced knee osteoarthritis. Previous studies have shown this to be an effective and safe method to reduce pain and improve functionality in this patient population.
Neurolysis of genicular nerves with radiofrequency (RF) may be useful to relieve pain and improve both function and quality of life in patients with post-TKA pain.
Investigators thought that reducing the pain of patients who underwent TKA with Fast-track in the postoperative period would contribute to early mobilization and therefore rapid functional recovery. As a result of previous studies, investigators know that genicular nerve neurolysis with RF Ablation in the preoperative period provides a reduction in postoperative pain.
Investigators routinely apply TKA applications in clinic with Fast-Track. In investigators hospital's algology outpatient clinic, genicular nerve RF ablation is routinely performed under USG or fluoroscopy guidance. In investigators study, investigators plan to compare the preoperative RF and genicular nerve ablation approach in patients who underwent TKA using the Fast-Track protocol in terms of meeting postoperative pain, function and early discharge criteria
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| TKA with radiofrequency ablation genicular nerve block | TKA with radiofrequency ablation genicular nerve block |
| |
| TKA without nerve block | TKA without radiofrequency ablation genicular nerve block |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Genicular nerve Radiofrequency Ablation block | Procedure | Genicular nerve Radiofrequency Ablation block |
|
| Measure | Description | Time Frame |
|---|---|---|
| Pain preoperative | Visual Analog Scale used to assess pain | Baseline (preoperatively) |
| Pain postoperative 1 | Visual Analog Scale used to assess pain | at postoperative sixth weeks |
| Pain postoperative 2 | Visual Analog Scale used to assess pain | at postoperative twelfth weeks |
| Knee Range of Motion preoperative | Digital goniometer used to assess knee range of motion | Baseline (preoperatively) |
| Knee Range of Motion postoperative 1 | Digital goniometer used to assess knee range of motion | at postoperative sixth week |
| Knee Range of Motion postoperative 2 | Digital goniometer used to assess knee range of motion | at postoperative twelfth week |
| Quadriceps muscle strength preoperative | Quadriceps muscle strength is measured (unit=newton(N)) with hand-held dynamometer | Baseline (preoperatively) |
| Quadriceps muscle strength postoperative 1 | Quadriceps muscle strength is measured (unit=newton(N)) with hand-held dynamometer |
| Measure | Description | Time Frame |
|---|---|---|
| Length of operation time | Length of operation time is measured in minutes during the surgery | the surgery |
| Amount of blood loss | Amount of blood loss is measured from the suction drainage (unit-milliliters) |
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Inclusion Criteria:
Exclusion Criteria:
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Inclusion Criteria:
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| HARUN R GUNGOR, MD | Contact | 258-296-5690 | +90 | hrgungor@gmail.com |
| MURAT I KIRBAS, MD | Contact | 506-783-0083 | +90 | mibrahimkirbas@gmail.com |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Pamukkale University | Recruiting | Denizli | Pamukkale | 20100 | Turkey (Türkiye) |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 35960987 | Background | Stake S, Agarwal AR, Coombs S, Cohen JS, Golladay GJ, Campbell JC, Thakkar SC. Total Knee Arthroplasty After Genicular Nerve Radiofrequency Ablation: Reduction in Prolonged Opioid Use Without Increased Postsurgical Complications. J Am Acad Orthop Surg Glob Res Rev. 2022 Aug 12;6(8):e22.00125. doi: 10.5435/JAAOSGlobal-D-22-00125. eCollection 2022 Aug 1. | |
| 22507716 |
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| ID | Term |
|---|---|
| D020370 | Osteoarthritis, Knee |
| ID | Term |
|---|---|
| D010003 | Osteoarthritis |
| D001168 | Arthritis |
| D007592 | Joint Diseases |
| D009140 | Musculoskeletal Diseases |
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| at postoperative sixth weeks |
| Quadriceps muscle strength postoperative 2 | Quadriceps muscle strength is measured (unit=newton(N)) with hand-held dynamometer | at postoperative twelfth week |
| Patient-reported activity limitations preoperative | The Western Ontario and McMaster Universities Arthritis Index and Knee injury and Osteoarthritis Outcome Score are used | Baseline (preoperatively) |
| Patient-reported activity limitations preoperative 1 | The Western Ontario and McMaster Universities Arthritis Index and Knee injury and Osteoarthritis Outcome Score are used | at postoperative sixth weeks |
| Patient-reported activity limitations preoperative 2 | The Western Ontario and McMaster Universities Arthritis Index and Knee injury and Osteoarthritis Outcome Score are used | at postoperative twelfth week |
| Performance-based activity limitations-preoperative | 30-sec chair-stand test and stair-climb test are used | Baseline (preoperatively) |
| Performance-based activity limitations-preoperative 1 | 30-sec chair-stand test and stair-climb test are used | at postoperative sixth weeks |
| Performance-based activity limitations-preoperative 2 | 30-sec chair-stand test and stair-climb test are used | at postoperative twelfth week |
| Quality of life-preoperative | Short Form-36 (SF-36) is used | Baseline (preoperatively) |
| Quality of life-preoperative 1 | Short Form-36 (SF-36) is used | at postoperative sixth weeks |
| Quality of life-preoperative 2 | Short Form-36 (SF-36) is used | at postoperative twelfth week |
| Length of hospital stay | Length of hospital stay is measured beginning from the hospitalization of the patient and ending at discharge of the patients (unit-hours) | through study completion, an average of 1 year |
| through study completion, an average of 1 year |
| postoperative component alignments | Long leg radiographs of the patients are evaluated postoperatively by using a digital orthopedic templating software-Materialise OrthoView (OrthoView version 7, Materialise HQ, Technologielaan 15 3001 Leuven, Belgium). | through study completion, an average of 1 year |
| Lloyd JM, Wainwright T, Middleton RG. What is the role of minimally invasive surgery in a fast track hip and knee replacement pathway? Ann R Coll Surg Engl. 2012 Apr;94(3):148-51. doi: 10.1308/003588412X13171221590214. |
| 21764515 | Background | Sullivan M, Tanzer M, Reardon G, Amirault D, Dunbar M, Stanish W. The role of presurgical expectancies in predicting pain and function one year following total knee arthroplasty. Pain. 2011 Oct;152(10):2287-2293. doi: 10.1016/j.pain.2011.06.014. Epub 2011 Jul 18. |
| D012216 |
| Rheumatic Diseases |