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Review
. 2022 Feb 17;1(1):100072.
doi: 10.1016/j.inpm.2022.100072. eCollection 2022 Mar.

The therapeutic effect of genicular nerve radiofrequency for chronic knee pain after a total knee arthroplasty: A systematic review

James B Meiling  1 , Brandon S Barndt  2 , Christopher T Ha  1 , James E Eubanks Jr  3 , Justin B Schappell  1 , George M Raum  3 , Samir A Khan  4 , Larry Prokop  5 , Aaron Conger  6 , Zachary L McCormick  6 , Christine L Hunt  7
Affiliations
Review

The therapeutic effect of genicular nerve radiofrequency for chronic knee pain after a total knee arthroplasty: A systematic review

James B Meiling et al. Interv Pain Med. .

Abstract

Objective: Summarize the therapeutic pain-reducing effects of GnRF for refractory post-TKA knee pain. A secondary objective was to summarize improvements in physical function after GnRF.

Methods: A protocol was registered, and a database search conducted by an experienced librarian of all available studies in the English language up until November 3, 2021. Study inclusion criteria were randomized controlled trials (RCTs), prospective and retrospective longitudinal studies, cross-sectional studies, case series, case reports, studies involving adults ≥18 years of age, and studies written about the use of GnRF for the alleviation of chronic knee pain after receiving a TKA. The study quality and risk of bias was assessed using NHLBI Study Quality of Assessment Tools and Murad et al.'s Quality Assessment of Case Reports. Certainty in the evidence was assessed using the Grading of Recommendations, Assessment, Development, and Evaluation approach.

Results: A total of 229 studies were screened, 11 met the inclusion criteria, and 265 patients underwent GnRF. Study designs included 1 double-blind pragmatic RCT, 5 retrospective cohort studies, 2 retrospective case series, and 3 case reports. The overall study quality assessment demonstrated three studies had "good", six "fair", and two "poor" quality. There have been positive responses to GnRF for post-TKA chronic knee pain in a range of 30-100% of patients.

Conclusions: According to GRADE, there is limited evidence, associated with low certainty to support the use of GnRF to ameliorate chronic knee pain after TKA, largely due to inconsistency and risk of bias. The studies included in this review reported positive results in pain and disability, and relatively few adverse events.

Keywords: Chronic knee pain; Genicular nerve; Radiofrequency; Systematic review; Total knee arthroplasty.

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Conflict of interest statement

The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Zachary L. McCormick, MD, serves on the Board of Directors of the Spine Intervention Society.

Figures

Fig. 1
Fig. 1
Preferred reporting items for systematic reviews and meta-analyses (PRISMA) flowchart of the study selection process.
Fig. 2
Fig. 2
Quality Assessment of Controlled Intervention Studies using NHLBI Tool.
Fig. 3
Fig. 3
Quality Assessment of Observational Cohort and Cross-Sectional Studies using NHLBI Tool.
Fig. 4
Fig. 4
Quality Assessment of Case Series Studies using NHLBI Tool.
Fig. 5
Fig. 5
Quality Assessment of Case Report Studies using Murad et al. Tool.
See this image and copyright information in PMC

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