Radiofrequency denervation for osteoarthritic knee pain
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3 Committee considerations
The evidence
3.1 NICE did a rapid review of the published literature on the efficacy and safety of this procedure. This comprised a comprehensive literature search and detailed review of the evidence from 9 sources, which was discussed by the committee. The evidence included 1 systematic review and network meta-analysis, 2 systematic reviews and meta-analyses, 1 randomised controlled trial, 1 long-term cohort study that was a single-arm extension of a randomised controlled trial, 1 cohort study, 1 narrative review, and 2 case reports. The evidence is presented in the summary of key evidence section in the interventional procedures overview. Other relevant literature is in the appendix of the overview.
3.2 The professional experts and the committee considered the key efficacy outcomes to be: pain relief, and improvements in quality of life, mobility and ability to exercise.
3.3 The professional experts and the committee considered the key safety outcomes to be: pain, infection, numbness, and damage to adjacent structures.
3.4 Patient commentary was sought but none was received.
Committee comments
3.5 The committee was informed that this procedure uses X‑ray screening to identify the nerves and in some centres ultrasound has replaced X‑ray.
3.6 The committee was informed that small volumes of local anaesthetic are used as a diagnostic procedure to identify the nerves.
3.7 The committee was informed that the typical duration of pain relief is less than 2 years and there is no long-term effect because of nerve regrowth.
Tom Clutton-Brock
Chair, interventional procedures advisory committee
February 2023
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