First non-surgical RFA for severe knee arthritis performed successfully in Ctg Labaid

A minimally invasive radiofrequency ablation (RFA) procedure has been performed for the first time in Chattogram to manage chronic pain caused by severe knee osteoarthritis, offering selected patients an alternative to knee replacement surgery.

Doctors at Labaid Specialised Hospital in the port city performed the procedure on a 60-year-old woman on Wednesday (23 September), saying the treatment was successful and the patient was doing well afterwards.

The patient, Shaheda Yasmin, had been suffering from knee pain for eight years and was a potential candidate for knee replacement. She has grade-4 chronic osteoarthritis along with diabetes and hypertension, and her condition had significantly affected her mobility.

The procedure was led by Dr Md Mahiuddin Majed Chowdhury, assistant professor of anaesthesia, pain, palliative, and intensive care at Chattogram Medical College Hospital.

He told The Business Standard that knee osteoarthritis is generally classified into four grades, with patients at grades 3 and 4 often experiencing severe pain that can interfere with normal movement.

"When patients put weight on their legs, they experience severe knee pain. Many have to walk with a stick. As a result, their jobs, mobility and normal lives are affected," he said.

According to the specialists, knee replacement may be necessary for some patients with advanced osteoarthritis. However, the surgery is complex and expensive, while access to such treatment remains limited in Bangladesh.

How RFA works

RFA targets specific nerves responsible for transmitting pain signals from the knee.

"We identify the specific nerve using ultrasound and a C-arm machine. We then apply a controlled temperature to the nerve using a radiofrequency ablation machine, reducing its ability to transmit pain signals," Dr Mahiuddin said.

The procedure generally takes 30-40 minutes and does not require hospitalisation or extensive preparation, he said.

For appropriately selected patients, the procedure can provide rapid pain relief and may keep pain under control for two to three years, according to the specialists. It may also reduce the need for regular painkillers during that period.

Dr Mahiuddin said RFA had been used for such patients in Bangladesh for about two years, with the service currently available at one or two private centres in Dhaka.

"This is the first time the treatment has been introduced in Chattogram," he said.

He cautioned that RFA is not suitable for every patient with knee problems. Doctors need to assess the patient's condition and the nature of the pain before deciding whether the procedure is appropriate.

Patients are also advised to avoid excessive pressure and weight-bearing on the affected knee and make necessary lifestyle changes after treatment.

Only three machines available in Bangladesh

According to treatment providers, only three radiofrequency ablation machines currently used for this procedure are available in Bangladesh.

The machine-use charge is around Tk30,000 per case, while the total treatment cost, including other expenses, may range from Tk60,000 to Tk70,000.

Dr Mahiuddin said the procedure could provide a new pain-management option for selected patients with chronic knee pain, particularly those who cannot undergo or prefer to avoid knee replacement surgery.