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Article ; Online: Alternative treatment of hip pain from advanced hip osteoarthritis utilizing cooled radiofrequency ablation: single institution pilot study.

Tran, Andrew / Reiter, David / Wong, Philip Kin-Wai / Fritz, Jan / Cruz, Anna R / Oskouei, Shervin / Gonzalez, Felix M

2021 Volume 51, Issue 5, Page(s) 1047–1054

Abstract: Objective: To establish the effectiveness of cooled radiofrequency ablation in managing hip pain from osteoarthritis at 6 months after receiving treatment in patients who failed conservative treatments and are not surgical candidates due to ... ...

Abstract	Objective: To establish the effectiveness of cooled radiofrequency ablation in managing hip pain from osteoarthritis at 6 months after receiving treatment in patients who failed conservative treatments and are not surgical candidates due to comorbidities or unwillingness to undergo arthroplasty surgery by targeting the femoral and obturator branches and assessing the degree of hip pain relief and change of function. Materials and methods: This prospective pilot study includes a total of 11 consecutive patients experiencing persistent chronic hip pain in the setting of advanced osteoarthritis. Patients initially underwent anesthetic blocks of the obturator and femoral nerve branches to determine cooled radiofrequency ablation candidacy. After adequate response to the anesthetic blocks (> 50% immediate pain relief), patients were subjected to the procedures 2-3 weeks later. Treatment response was evaluated utilizing clinically validated questionnaires and visual analog score in order to assess impact on pain severity, stiffness, and functional activities of daily living. Follow-up outcome scores were collected up to 6 months after cooled radiofrequency ablation procedure. Results: A total of 11 hips were treated consecutively between August 2019 and March 2020 (mean patient age 61.4 years; 8 M:3F). The mean total HOOS score improved significantly from baseline at 17.0 ± 6.0 to 52.9 ± 5.4 at a mean of 6.2 months after treatment (p < 0.0001), with significant improvement in mean pain score from 16.1 ± 6.6 to 53.4 ± 7.4 (p < 0.0001) and mean stiffness score from 15.0 ± 8.1 to 53.6 ± 11.0 (p < 0.0001). No major complications were encountered. No patients went on to re-treatment, surgery, or other intervention. Conclusion: Image-guided obturator and femoral nerve cooled radiofrequency ablation is effective and safe in treating chronic hip pain/stiffness in the setting of advanced osteoarthritis.
MeSH term(s)	Activities of Daily Living ; Humans ; Middle Aged ; Osteoarthritis, Hip/complications ; Osteoarthritis, Hip/diagnostic imaging ; Osteoarthritis, Hip/surgery ; Pain/etiology ; Pilot Projects ; Prospective Studies ; Radiofrequency Ablation/adverse effects ; Radiofrequency Ablation/methods ; Treatment Outcome
Language	English
Publishing date	2021-10-05
Publishing country	Germany
Document type	Journal Article
ZDB-ID	527592-1
ISSN	1432-2161 ; 0364-2348
ISSN (online)	1432-2161
ISSN	0364-2348
DOI	10.1007/s00256-021-03927-0
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Article ; Online: Management of uncomplicated total knee arthroplasty chronic pain and stiffness utilizing cooled radiofrequency ablation: a single institution pilot study.

Khan, Fiza M / Tran, Andrew / Wong, Philip Kin-Wai / Aiyedipe, Samuel / Loya, Mohammed F / Cristescu, Mircea M / Gonzalez, Felix M

Skeletal radiology

2021 Volume 51, Issue 6, Page(s) 1215–1223

Abstract: Objective: The objective of this study is to introduce cooled radiofrequency ablation technical feasibility as an alternative percutaneous image-guided treatment of chronic pain and stiffness in the setting of uncomplicated total knee arthroplasty.: ... ...

Abstract	Objective: The objective of this study is to introduce cooled radiofrequency ablation technical feasibility as an alternative percutaneous image-guided treatment of chronic pain and stiffness in the setting of uncomplicated total knee arthroplasty. Material and method: This retrospective pilot study includes a total of 19 consecutive patients experiencing persistent chronic pain after total knee arthroplasty, without underlying hardware complications who had failed conservative care. Patients initially underwent anesthetic blocks of the genicular nerve branches to determine C-RFA candidacy. After adequate response to the anesthetic blocks (> 50% immediate pain relief), patients were subjected to cooled radiofrequency ablations 2-3 weeks later. Treatment response was evaluated utilizing clinically validated questionnaires (KOOS, the Knee Injury and Osteoarthritis Outcome Score) and visual analog scale (VAS) to assess pain severity, stiffness, functional activities of daily living, and use of pain medication. Follow-up outcome scores were collected up to 1 year after C-RFA procedure. Result: A total of 21 knees were treated consecutively between 4/2019 and 1/2020 (mean age 70.5 years; 5 M:14F). The mean total KOOS score improved significantly from baseline at 35.0 ± 14.0 to 64.2 ± 14.7 at a mean of 10.2 months after treatment (p < 0.0001), with significant improvement in mean stiffness score from 44.8 ± 16.7 to 68.8 ± 20 (p < 0.0001). The mean VAS score improved significantly from baseline at 8.30 ± 1.1 to 2.45 ± 1.8 (p < 0.0001). No major complications were encountered. No patients went on to receive re-treatment, surgical revision, or other intervention. Conclusion: Image-guided genicular nerve cooled radiofrequency ablation offers a promising alternative in treating chronic pain/stiffness in the setting of uncomplicated TKA.
MeSH term(s)	Activities of Daily Living ; Aged ; Arthroplasty, Replacement, Knee ; Chronic Pain/diagnostic imaging ; Chronic Pain/surgery ; Humans ; Knee Joint/surgery ; Osteoarthritis, Knee/complications ; Osteoarthritis, Knee/diagnostic imaging ; Osteoarthritis, Knee/surgery ; Pilot Projects ; Radiofrequency Ablation/adverse effects ; Radiofrequency Ablation/methods ; Retrospective Studies ; Treatment Outcome
Language	English
Publishing date	2021-11-02
Publishing country	Germany
Document type	Journal Article
ZDB-ID	527592-1
ISSN	1432-2161 ; 0364-2348
ISSN (online)	1432-2161
ISSN	0364-2348
DOI	10.1007/s00256-021-03944-z
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Article: Alternate treatment approach to subchondral insufficiency fracture of the knee utilizing genicular nerve cooled radiofrequency ablation and adjunctive bisphosphonate supplementation: A case report.

Broida, Samuel Earl / Wong, Philip Kin-Wai / Umpierrez, Erica / Kakarala, Aparna / Reimer, Nickolas Bernard / Gonzalez, Felix M

Radiology case reports

2020 Volume 15, Issue 6, Page(s) 691–696

Abstract: Subchondral insufficiency fractures of the knee are commonly misdiagnosed fractures that are both very painful and difficult to treat. A conservative treatment modality to control symptoms during rehabilitation has not previously been described. This ... ...

Abstract	Subchondral insufficiency fractures of the knee are commonly misdiagnosed fractures that are both very painful and difficult to treat. A conservative treatment modality to control symptoms during rehabilitation has not previously been described. This case report presents the alternate use of cooled radiofrequency ablation technique of the genicular nerves for pain relief and bisphosphonate infusion to address the underlying poor bone mineralization/density with imaging follow-up before and after instituted treatments. A middle-aged female patient presenting with atraumatic pain in the medial aspect of the left knee diagnosed on an original magnetic resonance imaging as an insufficiency fracture and debilitating pain. Multiple-surgeon opinions of total knee arthroplasty were not a consideration the patient wanted or could consider given her lifestyle. Cooled radiofrequency ablation of the genicular nerve branches was performed with significant-complete pain relief achieved that lasted at least 6 months. Bisphosphonate infusions were instituted to address the underlying osteoporosis detected by a dual energy X-ray absorptiometry (DEXA) scan. Clinical performance after the radiofrequency ablations was followed with clinically validated surveys (The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC)/Knee Injury and Osteoarthritis Outcome Score (KOOS)) at 2 weeks, 1, 3, and 6 months. Patient was also asked to follow a restricted-modified weight-bearing plan for 3 months followed by physical therapy. Eight weeks apart of bisphosphonate infusions were delivered after proper administration of vitamin D. There was resolution of the insufficiency fracture at the medial femoral condyle between the magnetic resonance imaging exams within 4.5 months apart treated with restricted weight-bearing regimen. Pain resolution, significant improved function, and range of motion were the end results of our instituted treatment plan. This case reports presents an alternate pathway for the treatment of this condition especially when there is lack of consensus among physicians in how to best address this condition.
Language	English
Publishing date	2020-04-05
Publishing country	Netherlands
Document type	Case Reports
ZDB-ID	2406300-9
ISSN	1930-0433
ISSN	1930-0433
DOI	10.1016/j.radcr.2020.02.034
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Article ; Online: Safety and efficacy comparison of three- vs four-needle technique in the management of moderate to severe osteoarthritis of the knee using cooled radiofrequency ablation.

Wong, Philip Kin-Wai / Kokabi, Nima / Guo, Yi / Reiter, David / Reimer, Nickolas Bernard / Oskouei, Shervin / Gonzalez, Felix M

Skeletal radiology

2020 Volume 50, Issue 4, Page(s) 739–750

Abstract: Purpose: To analyze the safety and efficacy of image-guided genicular nerve cooled radiofrequency ablation (C-RFA) for the treatment of pain in non-surgical candidates with moderate to severe knee osteoarthritis (OA) and to compare three- vs four-needle ...

Abstract	Purpose: To analyze the safety and efficacy of image-guided genicular nerve cooled radiofrequency ablation (C-RFA) for the treatment of pain in non-surgical candidates with moderate to severe knee osteoarthritis (OA) and to compare three- vs four-needle technique. Method: This retrospective study included 50 consecutive patients with pain from moderate to severe knee OA refractory to anti-inflammatory analgesia that failed multiple intra-articular lidocaine-steroid injections and who were non-surgical total knee arthroplasty candidates because of comorbidities. Patients initially underwent anesthetic blocks of the superior medial/lateral femoral and inferior medial tibial genicular nerve branches and in some cases the suprapatellar genicular nerve branch. Radiofrequency ablations of the same nerve branches were performed 1-2 weeks after the nerve blocks. Follow-up outcome was collected at approximately 2 weeks, 1, 3, and 6 months after the C-RFA procedure utilizing VAS and clinically validated questionnaires. Results: A total of 77 knees were treated. The mean total KOOS score improved significantly from baseline at 24.7 ± 14.1 to 59.4 ± 26.5 at 6 months after treatment (p < 0.0001), with significant improvement in mean pain score from 25.5 ± 15.2 to 64.5 ± 25.2 (p < 0.0001) and mean stiffness score from 35.1 ± 21.9 to 65.8 ± 24.9 (p < 0.0001). At 6 months, 65% of all patients demonstrated decreased opiate medication usage, 79% of patients in the four-needle, and 45% of patients in the three-needle arms (p = 0.03). No complications were reported. Conclusions: The four-needle treatment approach offers an advantage in the overall efficacy in treating stiffness and pain in patients with moderate-to-severe OA refractory to conservative treatments leading to decreased opiate usage without complications.
MeSH term(s)	Humans ; Knee ; Knee Joint ; Osteoarthritis, Knee/diagnostic imaging ; Osteoarthritis, Knee/surgery ; Radiofrequency Ablation ; Retrospective Studies ; Treatment Outcome
Language	English
Publishing date	2020-09-24
Publishing country	Germany
Document type	Journal Article
ZDB-ID	527592-1
ISSN	1432-2161 ; 0364-2348
ISSN (online)	1432-2161
ISSN	0364-2348
DOI	10.1007/s00256-020-03619-1
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Article ; Online: 99mTc-Sestamibi Avid Soft Tissue Lesions in Rosai-Dorfman Disease.

Wong, Philip Kin-Wai / Lee, Daniel J / Harari, Saul / Barron, Bruce J

Clinical nuclear medicine

2016 Volume 41, Issue 12, Page(s) e508–e510

Abstract: Langerhan's histiocytosis is a not uncommon disease, but a related disorder, Rosai-Dorfman (RDD) with extensive or exclusive extranodal distribution, is relatively rare. Ga and PET/CT imaging have typically been used for diagnosis and tracking response ... ...

Abstract	Langerhan's histiocytosis is a not uncommon disease, but a related disorder, Rosai-Dorfman (RDD) with extensive or exclusive extranodal distribution, is relatively rare. Ga and PET/CT imaging have typically been used for diagnosis and tracking response to treatment. The authors present a very unusual case wherein lesions of RDD actively accumulated Tc-sestamibi, which was injected as part of a scan to localize a parathyroid adenoma.
MeSH term(s)	Histiocytosis, Sinus/diagnostic imaging ; Humans ; Lymph Nodes/diagnostic imaging ; Male ; Middle Aged ; Positron Emission Tomography Computed Tomography ; Radiopharmaceuticals ; Technetium Tc 99m Sestamibi
Chemical Substances	Radiopharmaceuticals ; Technetium Tc 99m Sestamibi (971Z4W1S09)
Language	English
Publishing date	2016-12
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	197628-x
ISSN	1536-0229 ; 0363-9762
ISSN (online)	1536-0229
ISSN	0363-9762
DOI	10.1097/RLU.0000000000001380
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Zs.A 1276: Show issues

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Article ; Online: Alternate treatment approach to subchondral insufficiency fracture of the knee utilizing genicular nerve cooled radiofrequency ablation and adjunctive bisphosphonate supplementation

Samuel Earl Broida, BS / Philip Kin-Wai Wong, MD / Erica Umpierrez, MD / Aparna Kakarala, MD / Nickolas Bernard Reimer, MD / Felix M. Gonzalez, MD

Radiology Case Reports, Vol 15, Iss 6, Pp 691-

A case report

2020 Volume 696

Abstract	Subchondral insufficiency fractures of the knee are commonly misdiagnosed fractures that are both very painful and difficult to treat. A conservative treatment modality to control symptoms during rehabilitation has not previously been described. This case report presents the alternate use of cooled radiofrequency ablation technique of the genicular nerves for pain relief and bisphosphonate infusion to address the underlying poor bone mineralization/density with imaging follow-up before and after instituted treatments. A middle-aged female patient presenting with atraumatic pain in the medial aspect of the left knee diagnosed on an original magnetic resonance imaging as an insufficiency fracture and debilitating pain. Multiple-surgeon opinions of total knee arthroplasty were not a consideration the patient wanted or could consider given her lifestyle. Cooled radiofrequency ablation of the genicular nerve branches was performed with significant-complete pain relief achieved that lasted at least 6 months. Bisphosphonate infusions were instituted to address the underlying osteoporosis detected by a dual energy X-ray absorptiometry (DEXA) scan. Clinical performance after the radiofrequency ablations was followed with clinically validated surveys (The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC)/Knee Injury and Osteoarthritis Outcome Score (KOOS)) at 2 weeks, 1, 3, and 6 months. Patient was also asked to follow a restricted-modified weight-bearing plan for 3 months followed by physical therapy. Eight weeks apart of bisphosphonate infusions were delivered after proper administration of vitamin D. There was resolution of the insufficiency fracture at the medial femoral condyle between the magnetic resonance imaging exams within 4.5 months apart treated with restricted weight-bearing regimen. Pain resolution, significant improved function, and range of motion were the end results of our instituted treatment plan. This case reports presents an alternate pathway for the treatment of this condition ...
Keywords	Knee ; SIFK ; MRI ; Bisphosphonate ; Ablations ; Medical physics. Medical radiology. Nuclear medicine ; R895-920
Subject code	616
Language	English
Publishing date	2020-06-01T00:00:00Z
Publisher	Elsevier
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article: What's in a name? Upper extremity fracture eponyms (Part 1).

Wong, Philip Kin-Wai / Hanna, Tarek N / Shuaib, Waqas / Sanders, Stephen M / Khosa, Faisal

International journal of emergency medicine

2015 Volume 8, Issue 1, Page(s) 75

Abstract: Eponymous extremity fractures are commonly encountered in the emergency setting. Correct eponym usage allows rapid, succinct communication of complex injuries. We will review both common and less frequently encountered extremity fracture eponyms, ... ...

Abstract	Eponymous extremity fractures are commonly encountered in the emergency setting. Correct eponym usage allows rapid, succinct communication of complex injuries. We will review both common and less frequently encountered extremity fracture eponyms, focusing on imaging features to identify and differentiate these injuries. We focus on plain radiographic findings, with supporting computed tomography (CT) images. For each injury, important radiologic descriptors are discussed which may need to be communicated to consultants. Aspects of management and follow-up imaging recommendations are included. This is a two-part review: Part 1 focuses on fracture eponyms of the upper extremity, while Part 2 covers fracture eponyms of the lower extremity.
Language	English
Publishing date	2015-07-30
Publishing country	England
Document type	Journal Article
ZDB-ID	2411462-5
ISSN	1865-1380 ; 1865-1372
ISSN (online)	1865-1380
ISSN	1865-1372
DOI	10.1186/s12245-015-0075-2
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: What's in a name? Lower extremity fracture eponyms (Part 2).

Wong, Philip Kin-Wai / Hanna, Tarek N / Shuaib, Waqas / Sanders, Stephen M / Khosa, Faisal

International journal of emergency medicine

2015 Volume 8, Issue 1, Page(s) 76

Abstract: Eponymous extremity fractures are commonly encountered in the emergency setting. Correct eponym usage allows rapid, succinct communication of complex injuries. We review both common and less frequently encountered extremity fracture eponyms, focusing on ... ...

Abstract	Eponymous extremity fractures are commonly encountered in the emergency setting. Correct eponym usage allows rapid, succinct communication of complex injuries. We review both common and less frequently encountered extremity fracture eponyms, focusing on imaging features to identify and differentiate these injuries. We focus on plain radiographic findings, with supporting computed tomography (CT) images. For each injury, important radiologic descriptors are discussed which may need to be communicated to clinicians. Aspects of management and follow-up imaging recommendations are included. This is a two-part review: Part 1 focuses on fracture eponyms of the upper extremity, while Part 2 encompasses fracture eponyms of the lower extremity.
Language	English
Publishing date	2015-07-25
Publishing country	England
Document type	Journal Article
ZDB-ID	2411462-5
ISSN	1865-1380 ; 1865-1372
ISSN (online)	1865-1380
ISSN	1865-1372
DOI	10.1186/s12245-015-0076-1
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Article ; Online: Radiographic assessment of the postoperative knee.

Younan, Yara / Wong, Philip Kin-Wai / Jose, Jean / Subhawong, Ty / Baraga, Michael / Umpierrez, Monica / Singer, Adam Daniel

Clinical imaging

2017 Volume 42, Page(s) 68–82

Abstract: Radiologists often encounter postoperative knee radiographs lacking any adjunct clinical data which might hinder accurate image interpretation. Surgical techniques are constantly evolving with new devices being used which make it sometimes challenging ... ...

Abstract	Radiologists often encounter postoperative knee radiographs lacking any adjunct clinical data which might hinder accurate image interpretation. Surgical techniques are constantly evolving with new devices being used which make it sometimes challenging for the radiologist to deduce the performed procedure and to look for associated complications. This article reviews commonly performed surgical procedures of the knee, highlights their expected postoperative radiographic appearance and describes the appearance of certain postoperative complications.
MeSH term(s)	Humans ; Knee Joint/diagnostic imaging ; Knee Joint/surgery ; Orthopedic Procedures ; Postoperative Complications/diagnostic imaging ; Postoperative Period ; Radiography
Language	English
Publishing date	2017-03
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	1028123-x
ISSN	1873-4499 ; 0899-7071
ISSN (online)	1873-4499
ISSN	0899-7071
DOI	10.1016/j.clinimag.2016.11.014
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Article: An international survey on recognition and characterization of atrophic gastritis and intestinal metaplasia.

Yip, Hon Chi / Uedo, Noriya / Chan, Shannon M / Teoh, Anthony Yuen Bun / Wong, Simon Kin Hung / Chiu, Philip W / Ng, Enders Kwok Wai

Endoscopy international open

2020 Volume 8, Issue 10, Page(s) E1365–E1370

Abstract: Background and study ... ...

Abstract	Background and study aims
Language	English
Publishing date	2020-09-22
Publishing country	Germany
Document type	Journal Article
ZDB-ID	2761052-4
ISSN	2196-9736 ; 2364-3722
ISSN (online)	2196-9736
ISSN	2364-3722
DOI	10.1055/a-1230-3586
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