Consensus Guidelines for Radiofrequency Ablation of Chronic Knee Pain in Rural Communities.

PURPOSE: Chronic Knee pain is one of the most reported types of pain in the United States and causes a significant issue in rural and underserved communities. Radiofrequency ablation (RFA) is a treatment that has shown significant improvement for up to 24 months for people suffering from chronic knee pain, but consensus guidelines for RFA in the management of chronic knee pain with emphasis on the unique aspects of rural health care have not been established. DESIGN: This quality improvement initiative utilized a literature review, initial needs assessment survey, and input from an expert panel of pain management providers. METHODS: A primary survey was distributed to an expert panel utilizing the Delphi method to acheive consensus guidelines for condition assessment, procedural details, and follow-up evaluation/recommendations. RESULTS: This initiative found that while most items reached consensus, procedural details remained the most contested category throughout each round particularly regarding RFA modalities, which ultimately favored cooled RFA for its superior and longer-lasting pain relief. CONCLUSION: The initiative was able to establish consensus guidelines for RFA of the knee which will improve patient outcomes by establishing best practices for patient selection, procedural techniques, and follow-up care. This will lead to more predictable pain relief, reduced opioid dependence, and improve quality of life.