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MR-guided focused ultrasound for the novel and innovative management of osteoarthritic knee pain
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...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2013
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3847454/ https://www.ncbi.nlm.nih.gov/pubmed/24034866 http://dx.doi.org/10.1186/1471-2474-14-267 |
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author | Izumi, Masashi Ikeuchi, Masahiko Kawasaki, Motohiro Ushida, Takahiro Morio, Kazuo Namba, Hirofumi Graven-Nielsen, Thomas Ogawa, Yasuhiro Tani, Toshikazu |
author_facet | Izumi, Masashi Ikeuchi, Masahiko Kawasaki, Motohiro Ushida, Takahiro Morio, Kazuo Namba, Hirofumi Graven-Nielsen, Thomas Ogawa, Yasuhiro Tani, Toshikazu |
author_sort | Izumi, Masashi |
collection | PubMed |
description | 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 |
format | Online Article Text |
id | pubmed-3847454 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2013 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-38474542013-12-04 MR-guided focused ultrasound for the novel and innovative management of osteoarthritic knee pain Izumi, Masashi Ikeuchi, Masahiko Kawasaki, Motohiro Ushida, Takahiro Morio, Kazuo Namba, Hirofumi Graven-Nielsen, Thomas Ogawa, Yasuhiro Tani, Toshikazu BMC Musculoskelet Disord Technical Advance 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 BioMed Central 2013-09-13 /pmc/articles/PMC3847454/ /pubmed/24034866 http://dx.doi.org/10.1186/1471-2474-14-267 Text en Copyright © 2013 Izumi et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Technical Advance Izumi, Masashi Ikeuchi, Masahiko Kawasaki, Motohiro Ushida, Takahiro Morio, Kazuo Namba, Hirofumi Graven-Nielsen, Thomas Ogawa, Yasuhiro Tani, Toshikazu MR-guided focused ultrasound for the novel and innovative management of osteoarthritic knee pain |
title | MR-guided focused ultrasound for the novel and innovative management of osteoarthritic knee pain |
title_full | MR-guided focused ultrasound for the novel and innovative management of osteoarthritic knee pain |
title_fullStr | MR-guided focused ultrasound for the novel and innovative management of osteoarthritic knee pain |
title_full_unstemmed | MR-guided focused ultrasound for the novel and innovative management of osteoarthritic knee pain |
title_short | MR-guided focused ultrasound for the novel and innovative management of osteoarthritic knee pain |
title_sort | mr-guided focused ultrasound for the novel and innovative management of osteoarthritic knee pain |
topic | Technical Advance |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3847454/ https://www.ncbi.nlm.nih.gov/pubmed/24034866 http://dx.doi.org/10.1186/1471-2474-14-267 |
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