Results of genicular nerve ablation by radiofrequency in osteoarthritis-related chronic refractory knee pain

Abstract

Background/aim: The aim of this study was to investigate the medium- to long-term effects of radiofrequency (RF) ablation of genicular nerves for chronic refractory knee pain due to osteoarthritis (OA).

Materials and methods: Forty-eight patients who underwent RF ablation of the genicular nerves were evaluated retrospectively. The visual analogue scale (VAS) score, Western Ontario and McMaster universities osteoarthritis index (WOMAC index), opioid and nonsteroidal antiinflammatory drug (NSAID) use score, quality of life score, and treatment satisfaction score were examined at 1, 3, and 6 months after the procedure.

Results: The mean VAS scores were significantly lower at the 1-, 3-, and 6-month evaluations compared with the preoperative values (P < 0.001). A significant decrease was observed in the WOMAC index compared with preoperative values (P < 0.001). It was found that 66.7% of opioid users and 56.3% of NSAID users stopped using medication. No serious complications were encountered during or after the procedure.

Conclusion: In chronic refractory knee pain due to OA, the application of RF ablation to the genicular nerve is an effective and safe treatment option in the medium to long term.

Keywords: Knee osteoarthritis; pain; genicular nerves; radiofrequency ablation.

Figure 1

Innervation of the anterior knee joint [29].

Figure 2

A: Anterior/posterior and B: lateral fluoroscopic images of the final electrode positions during conventional RF ablation of the genicular nerves.

Figure 3

Graphic for the change in VAS scores at different follow-up times. *Difference between baseline and month 1 is statistically significant (P < 0.001). ±Difference between baseline and month 3 is statistically significant (P < 0.001). €Difference between baseline and month 6 is statistically significant (P < 0.001). ¥Difference between month 1 and month 3 is statistically significant (P < 0.001). £Difference between month 3 and month 6 is statistically sign

Figure 4

Opioid usage scores during follow-up times. Data are as expressed as the percentage of patients. *At month 1 compared to baseline, decrease in opioid use and its discontinuation is statistically significant (P < 0.001). ±At month 3 compared to baseline, decrease in opioid use and its discontinuation is statistically significant (P < 0.001). €At month 6, decrease in opioid use and its discontinuation is statistically significant (P < 0.001).

Figure 5

NSAID usage scores during follow-up times. *At month 1 compared to baseline, decrease in NSAID use and its discontinuation is statistically significant (P < 0.001). €At month 3 compared to baseline, decrease in NSAID use and its discontinuation is statistically significant (P < 0.001). ±At month 6 compared to baseline, decrease in NSAID use and its discontinuation is statistically significant (P < 0.001).

Figure 6

Quality of life scores during follow-up times. *Month 1 quality of life scores significantly better (P < 0.05). ±Month 3 quality of life scores significantly better (P < 0.05). ¥Month 6 quality of life scores significantly better (P < 0.05).