A Feasibility Study of Percutaneous Peripheral Nerve Stimulation for the Treatment of Postoperative Pain Following Total Knee Arthroplasty

Introduction The objective of the present feasibility study was to investigate the use of a new treatment modality—percutaneous peripheral nerve stimulation (PNS)—in controlling the often severe and long‐lasting pain following total knee arthroplasty (TKA). Methods For patients undergoing a primary, unilateral TKA, both femoral and sciatic open‐coil percutaneous leads (SPR Therapeutics, Cleveland, OH) were placed up to seven days prior to surgery using ultrasound guidance. The leads were connected to external stimulators and used both at home and in the hospital for up to six weeks total. Results In six of seven subjects (86%), the average of daily pain scores across the first two weeks was 10% on the Six‐Minute Walk Test compared to preoperative levels, and WOMAC scores improved by an average of 85% compared to before surgery. No falls, motor block, or lead infections were reported. Conclusions This feasibility study suggests that for TKA, ultrasound‐guided percutaneous PNS is feasible in the immediate perioperative period and may provide analgesia without the undesirable systemic effects of opioids or quadriceps weakness induced by local anesthetics‐based peripheral nerve blocks.