title: The Treatment of Joint Pain with Intra-articular Pulsed Radiofrequency.
abstract: BACKGROUND
  The intra-articular (IA) application of pulsed radiofrequency (PRF) for pain in small and large joints represents a recent development that has proven to be effective in many cases. We performed a retrospective study of 89 such procedures in 57 consecutive patients with chronic articular pain.
  
  
  OBJECTIVE
  The aim of this retrospective study is to evaluate the effectiveness of intraarticular PRF in a group of 57 consecutive patients with chronic joint pain.
  
  
  METHODS
  Patients with intractable joint pain for more than 6 months were treated with IA PRF 40-45V for 10-15 min in small joints and 60V for 15 min in large joints using fluoroscopic confirmation of correct needle position. A total of 28 shoulders, 40 knees, 10 trapezio-metacarpal, and 11 first metatarso-phalangeal joints were treated. Results were evaluated at 1, 2, and 5 months. The procedure was repeated after 1 month in 10 patients with initial suboptimal results. Success was defined as a reduction of pain score by at least 50%.
  
  
  RESULTS
  All groups showed significant reductions in pain scores at all three follow-up visits. Success rates were higher in small joints (90% and 82%, respectively) than large ones (64% and 60%, respectively). Interestingly, IA PRF was successful in 6 out of 10 patients who had undergone previous surgery, including 3 with prosthetic joint replacement and in 6 of the 10 repeated procedures. There were no significant adverse effects or complications.
  
  
  CONCLUSIONS
  IA PRF induced significant pain relief of long duration in a majority of our patients with joint pain. The exact mechanism is unclear, but may be related to the exposure of immune cells to low-strength RF fields, inducing an anti-inflammatory effect. The success rate appears to be highest in small joints. We recommend additional research including control groups to further investigate and clarify this method; our data suggest that it may represent a useful modality in the treatment of arthrogenic pain.
authors.affiliation: S. Anna Clinic, Lugano, Switzerland.
authors.forename: Pietro M
authors.initials: PM
authors.lastname: Schianchi
authors.forename: Menno E
authors.initials: ME
authors.lastname: Sluijter
authors.forename: Susan E
authors.initials: SE
authors.lastname: Balogh
keywords: Allostasis; Arthralgia; Chemokines; Joint Prosthesis; Osteoarthritis; Pulsed Radiofrequency reatment