Background & Aims

Chronic knee pain affects about 25% of adults [1] and is known to be caused by various traumatic and atraumatic sources [2]. Pain management could be challenging in these patients, especially if they are not surgical candidates or surgery has already failed to provide adequate pain relief. A 60-day peripheral nerve stimulation (PNS) system is a promising novel treatment for neuropathic pain of various etiology. We report a case series on utilization of PNS for successful management of chronic knee pain of different etiology including pre- and post-operative knee pain.

Methods

Institutional Review Board approval was obtained. A retrospective review of patients who received PNS system for chronic knee pain was performed at an academic pain clinic. Patients had failed conservative treatment, and in some cases, total knee replacement surgery. Numerical pain scores (NRS) were collected prior to PNS implantation and at immediate post-op, 2 weeks, and 2 months post-implantation.

Results

Nineteen cases were included in the study. Peripheral nerve stimulator was implanted percutaneously on the femoral nerve and/or saphenous nerve. Complications for the procedure include lead migration (N=2) and skin irritation (N=1). The mean NRS was 7.58 pre-implantation (N=19), and 2.16 (N=19), 4.73 (N=12) and 4.4 (N=10) at immediate post-op, 2 weeks, and 2 months post-implantation respectively. At two-month follow-up, 79% of patients reported>50% ongoing pain relief.

Conclusions

We suggest PNS may provide clinically significant long-term reductions in chronic knee pain. Given minimally invasive nature of PNS, it may be used earlier in treatment protocol to minimize dysfunction from uncontrolled knee pain.

References

1. A Novel Knee Traction Technique to Treat Chronic Knee Pain. Tafler L, Ovshaev S, Ayon S, Luu A. Cureus. 2023 Aug 15;15(8).

2. Beutler Beutler, A. A., & Fields, K. K. UpToDate; [ Jun; 2023 ]. 2023. Approach to the adult with knee pain likely of musculoskeletal origin.

Presenting Author

Raheleh Rahimi Darabad

Poster Authors

Kristopher Rogers

MD

Indiana University School of Medicine, Indianapolis, IN, USA

Lead Author

Timothy Kelly

MD

Indiana University, Indianapolis, IN, USA

Lead Author

Michael Pazzol

DO

Lead Author

Raheleh Rahimi Darabad

MD

Indiana University School of Medicine, Indianapolis, IN, USA

Lead Author

Topics

  • Treatment/Management: Interventional Therapies – Neuromodulation