Effect Of Ultrasound-guided Denervation Combined With Silver Needle Heat Conduction On Knee Osteoarthritis

Objective This study aims to investigate the efficacy of ultrasound-guided denervation in combination with silver needles in the treatment of knee osteoarthritis(KOA)and provide a referenceforclinicaltreatmentof KOA.Methods A total of 120 patients diagnosed with KOAand grade 3-4 Kellgren-Lawrence and treated in the Pain Clinic of our hospital from September 2018 to September 2020 were enrolled in the present study.They were randomly divided into four groups:A(n=30),B(n=30),C(n=30)and D(n=30).Patients in the group Awere given sodium hyaluronate injection in their knees;patients in the group B received ultrasound-guided denervation;patients in the group C were treated with silverneedle diathermy;and patients in the group D adopted the ultrasound-guided denervation in combination with silverneedle diathermy.All the selected patients were given sodium hyaluronate injection(2ml: 20mg)in their knees.The improvement of range of motion(ROM),visual analogue scale(VAS)and knee function scores(Lysholm)were recorded and compared before operation,1 day,1 month,3 months and 6 months after operation ineachgroup.Results(1)The VAS scores of 1 day,1 month,3 months and 6 months after operation in the four groups were significantly decreased compared with those before operation while the scores of ROM and Lysholm were significantly improved.The difference was statistically significant(P<0.05).(2)The difference in VAS scores 1 day after operation was not statistically significant(P>0.05)between group C and group D.Whereas the VAS scores in the group D at the time points of 1 month,3 months and 6 months after operation were lower than those of other groups(A,B and C).The differencewas statistically significant(P<0.05).(3)The difference in Lysholm scores was not statistically significant(P>0.05)among group B,group C and group D at time points of 1 day after operation.The scores of the D group were significantly higher than those of the other three groups 1 month,3 months and 6 months afteroperation.Thedifferencewas statistically significant(P<0.05).(4)The ROM at time points of 1 day and 1 month after operation in the group B and group D was significantly higher than that in the group A and group C.The difference was statistically significant(P<0.05).Whereas the difference in ROM was not statistically significant(P>0.05)3 monthsand 6 monthsafter operation betweenthe group B andgroup C.Conclusion1.Ultrasound-guided knee denervation and silverneedle diathermy are effective in the treatment of KOA.2.The efficacy of ultrasound-guided knee denervation in combination with silverneedle diathermy is better than that of intra-articular injection of sodium hyaluronate or simple silver needle and denervation therapies in KOApatients with grade 3 K-L or above.The pain is better relieved in thecombined treatment,and the ROM andfunctionofjointsare clearly improved.