BMC Musculoskeletal Disorders | |
MR-guided focused ultrasound for the novel and innovative management of osteoarthritic knee pain | |
Toshikazu Tani4  Yasuhiro Ogawa2  Thomas Graven-Nielsen1  Hirofumi Namba4  Kazuo Morio2  Takahiro Ushida3  Motohiro Kawasaki4  Masahiko Ikeuchi4  Masashi Izumi4  | |
[1] Laboratory for Musculoskeletal Pain and Motor Control, Center for Sensory-Motor Interaction (SMI), Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark;Department of Radiology, Kochi Medical School, Kochi University, Nankoku, Japan;Multidisciplinary Pain Center, School of medicine, Aichi Medical University, Nagakute, Japan;Department of Orthopaedic Surgery, Kochi Medical School, Kochi University, Oko-cho Kohasu, Nankoku 783-850, Japan | |
关键词: Pain; Osteoarthritis; Knee; MR-guided Focused Ultrasound (MRgFUS); | |
Others : 1129768 DOI : 10.1186/1471-2474-14-267 |
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received in 2013-02-21, accepted in 2013-09-11, 发布年份 2013 | |
【 摘 要 】
Background
Severe knee pain associated with osteoarthritis (OA) is one of the most common and troublesome symptoms in the elderly. Recently, local bone denervation by MR-guided focused ultrasound (MRgFUS) has been demonstrated as a promising tool for pain palliation of bone metastases. The purpose of this study was to develop a novel treatment for knee OA using MRgFUS, and to validate its safety and efficacy.
Methods
Eight patients with medial knee pain and eligible for total knee arthroplasty were included. MR-guided focused sonication treatments were applied to bone surface just below the rim osteophyte of medial tibia plateau with real-time monitoring of the temperature in the target sites. The pain intensity during walking was assessed on a 100 mm visual analog scale (VAS) before and after treatment. Pressure pain thresholds (PPTs) were also evaluated over several test sites adjacent to the sonication area and control sites one month after treatment.
Results
Six patients (75%) showed immediate pain alleviation after treatment, and four of them demonstrated long-lasting effect at 6-month follow up (mean VAS reduction; 72.6%). In responders, PPTs in medial knee were significantly increased after treatment (Median; pre- 358 kpa vs post- 534 kpa, p?0.0001). There were no adverse side effects or complications during and after treatment.
Conclusions
These initial results illustrate the safety and efficacy of the newly developing MRgFUS treatment. Significant increase of PPTs on treated area showed successful denervation effect on the nociceptive nerve terminals. MRgFUS is a promising and innovative procedure for noninvasive pain management of knee OA.
Trial registration
Trial Registration:UMIN000010193
【 授权许可】
2013 Izumi et al.; licensee BioMed Central Ltd.
【 预 览 】
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Figure 1. | 71KB | Image | download |
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