Chronic osteoarthritis (OA) pain of the knee is often not effectively managed with current non-pharmacological or pharmacological treatments. Radiofrequency (RF) neurotomy is a therapeutic alternative for chronic pain. We investigated whether RF neurotomy applied to articular nerve branches (genicular nerves) was effective in relieving chronic OA knee joint pain. The study involved 38 elderly patients with (a) severe knee OA pain lasting more than 3 months, (b) positive response to a diagnostic genicular nerve block and (c) no response to conservative treatments. Patients were randomly assigned to receive percutaneous RF genicular neurotomy under fluoroscopic guidance (RF group; n=19) or the same procedure without effective neurotomy (control group; n=19). Visual analogue scale (VAS), Oxford knee scores, and global perceived effect on a 7-point scale were measured at baseline and at 1, 4, and 12weeks post-procedure. VAS scores showed that the RF group had less knee joint pain at 4 (p<0.001) and 12 (p<0.001) weeks compared with the control group. Oxford knee scores showed similar findings (p<0.001). In the RF group, 10/17 (59%), 11/17 (65%) and 10/17 (59%) achieved at least 50% knee pain relief at 1, 4, and 12 weeks, respectively. No patient reported a post-procedure adverse event during the follow-up period. RF neurotomy of genicular nerves leads to significant pain reduction and functional improvement in a subset of elderly chronic knee OA pain, and thus may be an effective treatment in such cases. Further trials with larger sample size and longer follow-up are warranted.
Chat generative pre-trained transformer (ChatGPT) is a chatbot developed by OpenAI that answers questions in a human-like manner. ChatGPT is a GPT language model that understands and responds to natural language created using a transformer, which is a new artificial neural network algorithm first introduced by Google in 2017. ChatGPT can be used to identify research topics and proofread English writing and R scripts to improve work efficiency and optimize time. Attempts to actively utilize generative artificial intelligence (AI) are expected to continue in clinical settings. However, ChatGPT still has many limitations for widespread use in clinical research, owing to AI hallucination symptoms and its training data constraints. Researchers recommend avoiding scientific writing using ChatGPT in many traditional journals because of the current lack of originality guidelines and plagiarism of content generated by ChatGPT. Further regulations and discussions on these topics are expected in the future.
Comparison of the effect of spinal anesthesia and general anesthesia on 5-year tumor recurrence rates after transurethral resection of bladder tumors Comparison of the effect of spinal anesthesia and general anesthesia on 5-year tumor recurrence rates after transurethral resection of bladder tumors