Durable Knee Pain Relief After 60-day PNS: Cross-sectional Survey Outcomes out to Five Years

Introduction: Knee pain is a leading cause of musculoskeletal complaints, affecting approximately 25% of adults1. Conservative treatments include physical therapy, NSAIDs, and intra-articular injections, but these options may provide limited pain relief. Given the limitations of current treatments and the high burden of knee pain, there is a need for minimally invasive treatments that provide durable relief. Percutaneous 60-Day Peripheral Nerve Stimulation (PNS) is a minimally invasive treatment shown to relieve pain and thereby improve function, including in a multicenter randomized placebo-controlled trial for patients with persistent postoperative knee pain2. This real-world cross-sectional survey sought to evaluate the durability of knee pain relief following Percutaneous 60-Day PNS treatment.

Methods: An IRB-approved cross-sectional survey was administered to patients who had completed Percutaneous 60-Day PNS treatment for knee pain, were at least 6 months from the start of treatment (SOT), and had reported at least 50% pain relief at the end of treatment. Outcomes included patient-reported percent pain relief; Patient Global Impression of Change (PGIC) in quality of life, physical function, mood, and sleep; and patient reports of use or avoidance of other major treatments or interventions for their knee pain since the Percutaneous 60-Day PNS treatment.

Results: Surveys were collected from 476 patients, and 80% (n=383 of 476) of patients reported durable improvements in at least one domain (≥50% pain relief and/or PGIC≥1 for quality of life, function, mood, and/or sleep) at the time of the survey, including 78% (n=51 of 65) of patients that were three to five years post-SOT (36-63 months). Outcomes were consistent across different causes of pain, with 80% (n=195 of 245) of patients with osteoarthritis, 81% (n=148 of 183) of patients with post-surgical pain, 89% (n=118 of 133) of patients with knee injury or trauma, and 81% (n=50 of 62) of patients with nerve injury or neuralgia reporting durable improvements. Across all patients, 76% (n=360 of 476) also reported avoiding subsequent major interventions (surgery, radiofrequency ablation, and permanent neurostimulator implants), and 81% (n=291 of 360) of these patients reported durable improvements in one or more domains. Safety outcomes were not assessed in this follow-up survey.

Conclusion: Percutaneous 60-Day PNS can provide durable relief for patients with knee pain, including different pain etiologies. Sustained improvements across multiple domains, observed even three to five years after treatment, highlight Percutaneous 60-Day PNS as a treatment option to provide long-term knee pain relief while avoiding subsequent major interventions.