Comparison of radiofrequency ablation of genicular nerve with genicular nerve block in patients with osteoarthritis of the knee

Background and Aim: Genicular nerve block has recently become a promising treatment option along with radiofrequency ablation in the management of osteoarthritis of the knee. Material and Methods: Sixty patients of age above 50 years with a pain pattern consistent with osteoarthritis of the knee, with their X-ray knee joint findings corresponding to their clinical symptoms, and with a failure to respond to conservative treatment were included in this study. The patients were divided into two groups of 30 each as follows: group I: patients were administered fluoroscope-guided radiofrequency ablation of genicular nerve using RF electrode set to a temperature of 60℃ for 120 sec and group II: patients were administered fluoroscope-guided genicular nerve block using 9 ml drug solution comprising 8 ml of 0.25% bupivacaine plus 1 ml (40 mg) of methylprednisolone. Results: Both techniques of knee injection were effective and provided good pain relief to the patients with symptomatic osteoarthritis of the knee. Pain scores were clinically less in group I compared to group II at all time intervals of the study period. However, they were statistically significant between the two groups at 2, 3, 6, and 12 months ( P < 0.05) with lesser Numerical Rating Scale in group I compared to group II. Western Ontario and McMaster Universities osteoarthritis index was clinically better in group I at all time intervals of the study period, but was statistically significant at 2 weeks, 1 month, and 12 months after the procedure ( P < 0.05). Conclusions: Fluoroscope-guided radiofrequency ablation of genicular nerve is better than fluoroscope-guided genicular nerve block in terms of improvement in pain score, physical status, and patient satisfaction.