DEVELOPMENT OF A MANAGEMENT ALGORITHM FOR PATIENTS WITH CHRONIC KNEE PAIN SYNDROME

Abstract

Introduction. Chronic knee pain syndrome is one of the leading causes of reduced functional activity and decreased quality of life. Conservative therapy often shows limited effectiveness, while surgical interventions carry significant risks. Modern minimally invasive techniques, particularly radiofrequency ablation (RFA), are considered promising due to their ability to reduce pain intensity and improve joint function. Therefore, the development of a structured patient management algorithm–including staged diagnostics, stratification, and determination of the optimal timing for RFA–is of high clinical relevance. Goal. To develop and substantiate a comprehensive management algorithm for patients with chronic knee pain syndrome, with an emphasis on identifying the optimal timing for radiofrequency ablation and defining the role of multidisciplinary support. Materials and Methods. The study utilized data from clinical observations, results of instrumental diagnostics (MRI, ultrasound, radiography), and clinical scoring scales (VAS, WOMAC, KOOS, SF-36). Dynamics of pain intensity and functional capacity at various follow-up intervals after RFA were analyzed. Patients were stratified according to the severity of structural changes and pain intensity. A generalized algorithm was developed, covering diagnostic evaluation, patient selection, timing of intervention, procedural implementation, and postoperative follow-up. Results. RFA demonstrated the highest effectiveness in patients with baseline VAS scores of 6–7 and preserved functional reserve: pain intensity decreased by 70–80% at three months and by 80–90% at six months. In patients with VAS scores of 8–9, outcomes were moderate-to-high (60–70% reduction at six months). In late-stage cases (VAS ≥ 9.5), effectiveness was moderate, with persistent functional limitations. A multidisciplinary approach–including an orthopedist, anesthesiologist, physical therapist, and psychologist–significantly enhanced the stability and long-term persistence of therapeutic outcomes. Conclusions. The management algorithm for chronic knee pain syndrome should include stepwise diagnostics, clinical and functional stratification, determination of the optimal timing for RFA, and a standardized multidisciplinary follow-up strategy. RFA is most effective when performed in patients resistant to conservative therapy but before irreversible degenerative joint changes occur. A comprehensive approach ensures sustained pain reduction, improved functional outcomes, and enhanced quality of life.