![]() ![]() However, 16–20% of all patients report chronic pain after the intervention 4. TKA is a reliable surgical procedure with positive long-term results 3. In the United States alone, about 600,000 total knee arthroplasties are performed annually, with a significant increase projected by 2030 2. ![]() Total knee replacement surgery (TKA) is a frequently performed elective procedure indicated for subjects with knee pain, refractory to conservative therapies 1. The average age of our population is increasing, resulting in a high incidence of chronic degenerative knee pathologies. Short-term results are promising and show considerable reductions in pain scores and opioid intake. The landmark-guided implantation technique is less invasive than classical neuromodulation techniques such as spinal cord or DRGS and complication rates remain low. Externally powered PNS at the saphenous nerve branches is a straightforward, selective and safe technique for patients with chronic knee pain. Additionally, subjects were able to reduce their opioid medication significantly after PNS therapy. These subjects reported significant improvements related to pain, quality of life, mood quality, and quality of sleep. The total study population reported included 25 patients. Two subjects were explanted due to wound infections. Six (18.2%) subjects reported non-sufficient initial benefit from the therapy and were explanted. Thirty-three patients received direct to permanent implant, landmark-guided peripheral nerve stimulation of the saphenous nerve branches. Additional data were collected for the subjects treated at the Charité location, including quality of life with the SF-36 form, quality of sleep with the Pittsburgh Sleep Quality Index and mood states with the short form of the General Depression Scale. Subject-reported outcome was measured via numerical rating scale values on a 10-point scale measuring pain intensity at rest and in motion. All implants were performed with an externally powered PNS system to avoid lead migration as a result of cross-joint lead positions tunneling towards an Implantable Pulse Generator to the trunk. Patients suffering from chronic intractable post-surgical knee pain received landmark-guided peripheral nerve stimulation of the branches of the saphenous nerve. This study aimed to investigate the safety and efficacy externally powered PNS systems for the treatment of chronic intractable knee pain targeting the saphenous nerve. The evidence for peripheral nerve stimulation (PNS) is minimal due to a limited number of neuromodulation systems capable of targeting the distal part of the lower limbs. Neuromodulation techniques such as spinal cord stimulation and dorsal root ganglion stimulation (DRGS) are treatment options for subjects with chronic knee pain. However, the percentage of subjects with chronic post-surgical knee pain is still estimated at 16–20%. Several treatment options, including surgical procedures are available to help mitigate these pathologies. ![]()
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