Cooled Radiofrequency Ablation Versus Cryoneurolysis of the Genicular Nerves for the Symptomatic Pain Management in Knee Osteoarthritis: A Prospective, Randomized, Single-Blinded Clinical Trial

This is the authors' abstract. We don't add key points for this paper.

PURPOSE: Knee osteoarthritis (KOA) is a common disease that significantly affects the quality of life of patients. Among several nonsurgical methods of symptomatic treatment, cooled radiofrequency ablation (CRFA) and cryoneurolysis (CRYO) have gained traction recently. This study compared the two methods in their capacity to reduce pain and improve clinical outcomes in patients with KOA. METHODS: This was a prospective, randomized, single-blinded clinical trial that included 25 patients with KOA in each group. The classic targets of the superior lateral and medial genicular and inferior medial genicular nerves were used, as well as the medial (retinacular) genicular branch from the vastus intermedius. Patients were evaluated using the Numerical Pain Scale (NRPS), the Knee Injury and Osteoarthritis Outcome Score (KOOS), and the Oxford Knee Score (OKS) at baseline and at one, three, and six months post-intervention. RESULTS: Both methods were able to reduce pain and display improved clinical outcomes in all three post-intervention evaluations. However, at the six-month mark, CRFA showed a clear advantage: NRPS decreased from a baseline mean of 7 to 3.1 (compared to 6.2 for cryoneurolysis); KOOS improved from a baseline mean of 45.4 to 64 (compared to 56 for cryoneurolysis); OKS improved from a baseline mean of 20 to 33 (compared to 26 for cryoneurolysis). No serious procedure-related adverse events were reported. CONCLUSIONS: Both CRFA and cryoneurolysis of the genicular nerves are effective treatment options for KOA symptoms. However, CRFA displays a more durable therapeutic effect after the one-month period, with a clear advantage at the six-month evaluation.