Effectiveness of the Cooled Radiofrequency Ablation of Genicular Nerves in Patients with Chronic Knee Pain

Background: Multiple modalities are existing for chronic knee pain management. Genicular nerve neurolysis/Rhyzotomy and intra-articular steroid injection (IASI) are available treatment options for patients with knee osteoarthritis. There is increasing evidence supporting the effectiveness of cooled radiofrequency ablation (RFA) in treating genicular nerves for patients with chronic knee osteoarthritis (OA). This study aims to compare the efficacy of cooled RFA with that of intra-articular steroid injection (IASI) in patients with knee pain caused by OA. Aims and Objectives: The primary objective of this observational, prospective study was to evaluate the longterm outcomes, including pain, function, and perceived effect of treatment, in subjects undergoing cooled radiofrequency ablation (CRFA) who have pain due to osteoarthritis (OA) of the knee. Methods: The prospective observational type of study was carried out on thirty patients with Kellgren–Lawrence grade 2–4 knee OA in the department of Anaesthesiology at Gandhi Medical College Bhopal after the approval of Institutional Ethics Committee of our hospital. The patients were assigned into 2 groups randomly as IASI (N=15) and CRFA (N=15) group. All the patients were evaluated with Visual analogue score (VAS) for pain intensity and Western Ontario and Mc Master Universities Osteoarthritis Index (WOMAC) for functional status of the patients. All assessments were measured and compared at baseline, 1 month, 3 month and 6th month after treatment. Furthermore, patient satisfaction was also recorded. Results: All evaluation parameters were significantly improved in IASI and CRFA groups. Both VAS and WOMAC score of CRFA group were significantly lower than VAS and WOMAC score of IASI group during all the intervals of time (p<0.001). Satisfaction grades did not differ between the two groups. Conclusions: Cooled radiofrequency ablation (CRFA) of the genicular nerve and intra-articular steroid injection (IASI) are potential treatments for knee joint pain in osteoarthritis. However, CRFA provides better pain relief and enhances functional capacity in patients with knee joint pain from osteoarthritis compared to IASI.