Efficacy of a Modified Three-in-One Puncture Technique for Genicular Nerve Ablation in Knee Osteoarthritis

Introduction: Conventional approaches targeting the superior medial genicular nerve (SMGN), superior lateral genicular nerve (SLGN), and inferior medial genicular nerve (IMGN) have demonstrated favourable outcomes in knee joint. However, because the inferior lateral genicular nerve (ILGN) and the joint capsule branch are not intervened, radiofrequency ablation of the knee joint cannot completely alleviate knee pain. Our research team has developed an innovative three-in-one puncture technique for the knee, by altering the puncture entry point, simultaneous intervention of three nerves—the SLGN, the inferior lateral genicular nerve, and the joint capsule branch—is enabled. The three-in-one puncture technique has shown preliminarily promising results in patients with knee osteoarthritis (OA). Methods: We included 57 patients for retrospective analysis. All patients underwent knee nerve radiofrequency ablation(RFA) at the Pain Department of Taihe Hospital, from March 2021 to March 2023. Among them, 30 patients received treatment using the innovative three-in-one method, and 27 received treatment using the traditional method. Follow-up assessments were performed preoperatively and at postoperative Day 1, week 1, month 1, month 3, and month 6 using the numerical rating scale (NRS) for pain, surgical complications, and patient satisfaction. Results: NRS scores significantly decreased in both groups at all postoperative time points. Intergroup comparisons revealed statistically significant differences in the NRS scores between the three-in-one group and the traditional group at postoperative months 1, 3, and 6 ( P < 0.05). No severe adverse events were observed in either group. At 6 months postsurgery, 93.3% of patients in the three-in-one group were satisfied with the outcomes, compared to 74.1% satisfaction in the traditional group. Conclusion: The three-in-one method significantly reduced chronic peri-knee pain intensity. Long-term follow-up demonstrates its longer-lasting analgesic effects and higher patient satisfaction, indicating substantial clinical applicability. Plain Language Summary: Traditional treatments targeting the superior medial genicular nerve (SMGN), superior lateral genicular nerve (SLGN), and inferior medial genicular nerve (IMGN) have demonstrated favorable outcomes. However, in our clinical practice, we have observed that pain relief in patients remains incomplete, as the inferior lateral genicular nerve (ILGN) and the joint capsule branch are not addressed. The innovative three-in-one approach enables the simultaneous intervention of three nerves—the SLGN, the inferior lateral genicular nerve, and the joint capsule branch—with a single puncture. This method ensures more thorough and safer radiofrequency management of pain caused by knee osteoarthritis. We hope this minor technical improvement can become the new standard for knee joint radiofrequency.