Ultrasound-Guided Genicular Nerve Pulsed Radiofrequency Treatment For Painful Knee Osteoarthritis: A Preliminary Report.

BACKGROUND Genicular nerve ablation with radiofrequency (RF) has recently emerged as a promising treatment in the management of osteoarthritis related knee pain. To date, genicular nerve injections have been performed under fluoroscopic guidance. OBJECTIVE To evaluate the effect of ultrasound-guided genicular nerve pulsed RF treatment on chronic knee pain and function in patients with knee osteoarthritis. STUDY DESIGN Single-arm prospective study. SETTING University hospital and rehabilitation center in Turkey. METHODS A review was made of 29 patients with medial knee osteoarthritis who had undergone genicular nerve block in the previous 6 months. Patients with at least 50% reduction in the visual analog scale (VAS) score after genicular nerve block and with no on-going pain relief were selected for the study. Ultrasound-guided genicular nerve pulsed RF was applied to 15 knees of 9 patients. Pain and knee function were assessed with 100-mm VAS and Western Ontario and McMaster Universities (WOMAC) index throughout 3 months. RESULTS A significant reduction in VAS scores was detected over time after the pulsed RF procedure (f: 69.24, P < 0.01). There was a significant improvement in the WOMAC scores (f: 539.68 , P < 0.01). LIMITATIONS The small number of participants, the lack of a control group, and short follow-up period were limitations of the study. CONCLUSIONS Genicular nerve pulsed RF treatment has been found to be safe and beneficial in osteoarthritis related knee pain. Further studies with a larger population and randomized controlled study design are warranted to confirm the positive findings of this preliminary report.