Nerve Ablation by Cooled Radiofrequency Compared to Corticosteroid Injection for Management of Knee Pain

Completed · Not applicable

Conditions studied: Osteoarthritis of the Knee

In brief

This study is designed to: * Determine the effectiveness (primarily measured by pain relief) of Coolief when used to create radiofrequency lesions of the genicular nerves compared to pain relief following corticosteroid injection; and * Confirm the safety of Coolief when used to perform radiofrequency lesions of the genicular nerves in subjects to manage knee pain compared to safety of corticosteroid injection

Key facts

Study ID

NCT02343003

Run by

Halyard Health

People needed

151

Starts

2015-01-01

Expected to finish

2017-03-16

Last updated by the study team

2019-05-13

Who can join

Age: 21 and older. Sex: any. Healthy volunteers: not accepted.

You may qualify if…

• Age ≥ 21 years
• Able to understand the informed consent form and provide written informed consent and able to complete outcome measures
• History of chronic knee pain for longer than 6 months unresponsive to conservative treatments (PT, oral analgesics, intra-articular injections with steroids and/or viscosupplementation)
• Positive response (defined as a decrease in numeric pain scores of at least 50%) to a geniculate nerve block of the index knee
• Pain on NRS ≥ 6 on a 10 point scale for the index knee
• Radiologic confirmation of osteoarthritis (x-ray/MRI/CT) of OA grade of 2 (mild), 3 (moderate) or 4 (severe) noted within 12 months for the index knee
• Oxford Knee Score group at Baseline of ≤ 35 indicating moderate to severe OA in the index knee
• If the patient is taking an opioid or other morphine equivalent medication, the dose must be considered clinically stable (defined as <10% change in dosage for ≥ 2 months prior to the screening visit).
• Analgesics including membrane stabilizers such as Neurontin and antidepressants for pain such as Cymbalta must be clinically stable (defined as stable dosage for ≥ 6 weeks prior to the screening visit) and shall not change during the course of the study without approval of investigator. Agree to see one pain doctor (study investigator) for knee pain during the study period
• Index knee pathology that is consistent with generally accepted indications for total knee arthroplasty.
• Willing to delay any surgical intervention for the index knee for 12 months.
• Willingness to provide informed consent and to comply with the requirements of this protocol for the full duration.

You may not qualify if…

• Pseudo arthritis, rheumatoid arthritis or other systemic inflammatory arthritis condition that could cause knee pain.
• Previous or pending lower limb amputation.
• Intra-articular steroid, platelet rich plasma (PRP) or hyaluronic acid injections in the index knee within 90 days from the screening visit.
• An intra-articular corticosteroid injection is not indicated as an appropriate treatment option.
• Prior radiofrequency of the genicular nerves of the index knee.
• Prior partial, resurfacing, or total knee arthroplasty in index knee.
• Clinically significant ligamentous laxity of the index knee.
• Evidence of structural abnormality other than osteoarthritis of knee, hip or back that materially affects gait or function of the knee or is the underlying cause of the knee pain.
• BMI > 40.
• Extremely thin patients and those with minimal subcutaneous tissue thickness that would not accommodate a lesion of up to 14 mm in diameter to limit the risk of skin burns.
• Pending or active compensation claim, litigation or disability remuneration (secondary gain) related to knee.
• Pregnant or intent of becoming pregnant during the study period.
• Chronic pain associated with significant psychosocial dysfunction.
• Beck's Depression Index score of > 22 (indicates clinically depressed state).
• Allergies to any of the medications to be used during the procedure.
• Systemic or localized infection at needle entry sites (subject may be considered for inclusion once infection is resolved).
• History of uncontrolled coagulopathy, ongoing coagulation treatment or unexplained or uncontrollable bleeding that is uncorrectable.
• Identifiable anatomical variability that would materially alter the procedure as described in the protocol.
• Within the preceding 2 years, subject has suffered from active narcotic addiction, substance or alcohol abuse.
• Current prescribed opioid medications equivalent to greater than 60 morphine equivalent daily opioid dose.
• Uncontrolled immunosuppression (e.g. AIDS, cancer, diabetes, etc.)
• Subject currently implanted with pacemaker or defibrillator.
• Participating in another clinical trial/investigation within 30 days prior to signing informed consent.
• Subject unwilling or unable to comply with follow up schedule or protocol requirements.

Where it is running

• Valley Anesthesiology Consultants - Estrella — Phoenix, Arizona, United States
• Valley Anesthesiology Consultants/Valley Pain Consultants — Scottsdale, Arizona, United States
• Orthopedic Pain Specialists — Santa Monica, California, United States
• Rush University Medical Center — Chicago, Illinois, United States
• MAPS Applied Research Center, Inc. — Maple Grove, Minnesota, United States
• Ainsworth Institute of Pain Management — New York, New York, United States
• Center for Clinical Research — Winston-Salem, North Carolina, United States
• Drexel University — Philadelphia, Pennsylvania, United States
• Piedmont Comprehensive Pain Management — Greenville, South Carolina, United States
• Virginia iSpine Physicians — Richmond, Virginia, United States
• Advanced Pain Management — Greenfield, Wisconsin, United States

Full record on ClinicalTrials.gov

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