In a recent paper, we describe a potential method for thermal radiofrequency (TRF) for ablation of the saphenous nerve with a view to developing a technique that may provide analgesia for dogs with intractable stifle osteoarthritis (
Boesch et al., 2019). We showed that TRF could produce lesions in target nerves similar to those reported in humans undergoing therapeutic denervation. Safety was not demonstrated in dogs with naturally-occurring pain, and neither was efficacy proven. The purpose of this letter is to urge extreme caution in applying this technique. Although TRF ablation has provided pain relief in clinical canine patients, the owners of two dogs enrolled in a clinical trial of saphenous TRF ablation have reported substantial worsening of the signs associated with stifle pain; in one dog, pain worsened for a month before improving markedly at 3 months, and a second dog is currently undergoing treatment for increased pain. These adverse responses could be transient neuropathic pain, as has been described in humans after radiofrequency denervation of the third occipital nerve (
- Boesch J.M.
- Campoy L.
- Southard T.
- et al.
Histological, electrophysiological and clinical effects of thermal radiofrequency therapy of the saphenous nerve and pulsed radiofrequency therapy of the sciatic nerve in dogs.
Vet Anaesth Analg. 2019; 46: 689-698
Gazelka et al., 2014). However, other possible causes cannot be ruled out including neuritis, thermal damage to non-target tissues, failure of the TRF accompanied by natural progression of the osteoarthritis, anatomical variability or other technical problems. Investigation of TRF of the saphenous nerve in clinical canine patients is ongoing.
- Gazelka H.M.
- Knievel S.
- Mauck W.D.
- et al.
Incidence of neuropathic pain after radiofrequency denervation of the third occipital nerve.
J Pain Res. 2014; 7: 195-198
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- Histological, electrophysiological and clinical effects of thermal radiofrequency therapy of the saphenous nerve and pulsed radiofrequency therapy of the sciatic nerve in dogs.Vet Anaesth Analg. 2019; 46: 689-698
- Incidence of neuropathic pain after radiofrequency denervation of the third occipital nerve.J Pain Res. 2014; 7: 195-198
© 2020 Published by Elsevier Ltd on behalf of Association of Veterinary Anaesthetists and American College of Veterinary Anesthesia and Analgesia.