MR-guided Focused Ultrasound for the Novel and Innovative Management of Osteoarthritic Knee Pain

Overview

Journal BMC Musculoskelet Disord

Publisher Biomed Central

Specialties Orthopedics
Physiology

Date 2013 Sep 17

PMID 24034866

Citations 10

Authors

Masashi Izumi

Masahiko Ikeuchi

Motohiro Kawasaki

Takahiro Ushida

Kazuo Morio

Hirofumi Namba

Thomas Graven-Nielsen

Yasuhiro Ogawa

Toshikazu Tani

Affiliations

Soon will be listed here.

Abstract

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.

Citing Articles

Update on musculoskeletal applications of magnetic resonance-guided focused ultrasound.

McGill K, Baal J, Bucknor M Skeletal Radiol. 2024; 53(9):1869-1877.

PMID: 38363419 PMC: 11303439. DOI: 10.1007/s00256-024-04620-8.

Focused Ultrasound (FUS) for Chronic Pain Management: Approved and Potential Applications.

di Biase L, Falato E, Caminiti M, Pecoraro P, Narducci F, Di Lazzaro V Neurol Res Int. 2021; 2021:8438498.

PMID: 34258062 PMC: 8261174. DOI: 10.1155/2021/8438498.

An Introduction to High Intensity Focused Ultrasound: Systematic Review on Principles, Devices, and Clinical Applications.

Izadifar Z, Izadifar Z, Chapman D, Babyn P J Clin Med. 2020; 9(2).

PMID: 32046072 PMC: 7073974. DOI: 10.3390/jcm9020460.

Effects of MRgFUS Treatment on Musculoskeletal Pain: Comparison between Bone Metastasis and Chronic Knee/Lumbar Osteoarthritis.

Namba H, Kawasaki M, Izumi M, Ushida T, Takemasa R, Ikeuchi M Pain Res Manag. 2019; 2019:4867904.

PMID: 31565109 PMC: 6745150. DOI: 10.1155/2019/4867904.

Emerging clinical applications of high-intensity focused ultrasound.

Duc N, Keserci B Diagn Interv Radiol. 2019; 25(5):398-409.

PMID: 31287428 PMC: 6727814. DOI: 10.5152/dir.2019.18556.

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