Therapeutic effect of fluoroscopy-guided genicular nerve radiofrequency ablation for chronic knee pain: A retrospective clinical study
TL;DR
Preliminary findings suggest that RFA may merit further study as a non-surgical option for chronic knee OA pain in patients unfit for or unwilling to undergo knee arthroplasty.
Abstract
Knee osteoarthritis (OA) causes chronic pain and functional limitation in older adults, and conventional treatments often give limited long-term relief. Radiofrequency ablation (RFA) of the genicular nerves is a minimally invasive option for refractory knee pain. This study assessed the short-term effect of image-guided genicular nerve RFA (GnRF) on pain in a small retrospective series of patients with chronic knee OA. A retrospective single-center study was conducted in 21 patients (mean age 62.7 ± 5.7 years) with moderate-to-severe knee OA who had failed conservative management. Under fluoroscopic guidance, RFA was performed at 60°C for 180 s, targeting the superior medial, superior lateral, and inferior medial genicular nerves. Pain was assessed using a 10-cm Visual Analog Scale (VAS) at baseline and at 3, 6, and 12-month post-procedure. Mean VAS pain scores significantly decreased from 8.9 ± 0.7 at baseline to 4.7 ± 0.9 at 3 months, 3.3 ± 0.9 at 6 months, and 2.4 ± 0.9 at 1 year ( p < 0.001). The post hoc comparisons revealed significant reductions across all time points (all p < 0.05). In this uncontrolled case series, GnRF was associated with a significant, progressive reduction in VAS pain scores maintained through 1 year. Without a control group, this cannot be separated from the natural course of pain or a placebo response. These preliminary findings suggest that RFA may merit further study as a non-surgical option for chronic knee OA pain in patients unfit for or unwilling to undergo knee arthroplasty.