AB1189 BOTULINUM TOXIN TYPE A OR SELECTIVE GENICULAR PULSED RADIOFREQUENCY FOR TREATING ADVANCED KNEE OSTEOARTHRITIS

Background

Knee osteoarthritis was the most common type (6% of all adults). Developing osteoarthritis increases with age. Pain is a key symptom in the decision to seek medical care and is an important antecedent to disability.

Objectives

To discuss the effectiveness, indications, limitations and side effects of botulinum toxin type A and genicular nerves pulsed radiofrequancy for treating osteoarthritis to help clinicians choose the most appropriate treatment.

Methods

Randomized double blind controlled trial study, fifty two participants were recruited divided into 2 groups as follows:Group I (Bx): 25 patients given intra-articular botulinum toxin type A 100 IU sonographically guided in patient with osteoarthritis knee according to American Collage of Rheumatology criteria and in stage 3 or 4 of the Kellgren_Lawrence classification Group II (RF): 27 patient get radiofrequncy ablation of genicular nerves. The primery outcome was Visual analogue pain score (VAS), secondry outcome was stiffness, physical function of each knee using Western Ontario and McMaster University Osteoarthritis Index (WOMAC), and Calculation of Oxford knee score at base line, 4,8,12 and 24 weeks.

Results

16 female and 9 male in group I versus 10 female and 17 male in group II. The mean age were 54.36±7.8 years, there was significant difference in pain VAS between groups at 4^th week (P value = 0.005). A significant difference in WOMAC pain at 4^th and 12^th weeks (P value > 0.001), WOMAC stiffness at 12^th and 24^th weeks (P value > 0.001), WOMAC function 4^th, 12^th and 24^th weeks (P value > 0.001) and WOMAC total at 4^th, 12^th and 24^th weeks (P > 0.001).However there were no significant difference in Oxford between the two groups.

Conclusion

Intra-articular Botulinum toxin type A 100 IU can reduce the overall pain and improve the function in Knee osteoarthritis with higher effecacy than Pulsed Radiofrequancy. However. Further research is needed to compare the effect of botulinum toxin type A and Radiofrequancy for the different stages of Osteoarthritis.

REFERENCES:

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Acknowledgements:

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Disclosure of Interests

None Declared.