Therapeutic effect of fluoroscopy-guided genicular nerve radiofrequency ablation for chronic knee pain: A retrospective clinical study

Objectives: Knee osteoarthritis (OA) causes chronic pain and functional limitation in older adults, and conventional treatments often give limited long-term relief. Radiofrequency ablation (RFA) of the genicular nerves is a minimally invasive option for refractory knee pain. This study assessed the short-term effect of image-guided genicular nerve RFA (GnRF) on pain in a small retrospective series of patients with chronic knee OA. Methods: A retrospective single-center study was conducted in 21 patients (mean age 62.7 ± 5.7 years) with moderate-to-severe knee OA who had failed conservative management. Under fluoroscopic guidance, RFA was performed at 60°C for 180 s, targeting the superior medial, superior lateral, and inferior medial genicular nerves. Pain was assessed using a 10-cm Visual Analog Scale (VAS) at baseline and at 3, 6, and 12-month post-procedure. Results: Mean VAS pain scores significantly decreased from 8.9 ± 0.7 at baseline to 4.7 ± 0.9 at 3 months, 3.3 ± 0.9 at 6 months, and 2.4 ± 0.9 at 1 year ( p < 0.001). The post hoc comparisons revealed significant reductions across all time points (all p < 0.05). Conclusion: In this uncontrolled case series, GnRF was associated with a significant, progressive reduction in VAS pain scores maintained through 1 year. Without a control group, this cannot be separated from the natural course of pain or a placebo response. These preliminary findings suggest that RFA may merit further study as a non-surgical option for chronic knee OA pain in patients unfit for or unwilling to undergo knee arthroplasty.