Radiofrequency Denervation of Genicular Nerves for Advanced Knee Osteoarthritis Pain: A retrospective Observational Study

Abstract

Background: Knee joint osteoarthritis is a degenerative disorder resulting in pain and disability. The treatment of knee osteoarthritis pain includes the use of oral analgesics, oral glucosamine and chondroitin sulfate, intra-articular steroid, and viscous supplementation, but with limited efficacy. Aim of the work: This retrospective observational study aimed to evaluate the efficacy of radiofrequency thermocoagulation of genicular nerves for control of the pain of knee joint osteoarthritis. Material and methods: This study included patients with knee pain of Kellgren Lawrence grade 3 and 4 osteoarthritis who underwent radiofrequency neurotomy of the knee joint from July 2015 to July 2018. The 68 joints of 60 patients were evaluated for knee pain VAS score [0–10 mm], oxford knee score [12–60] and development of any adverse effect at pre and post-procedure at 1, 3, 6 and 12 months. Results: The mean± SD values of Visual analog scale [VAS] [0–10] for knee joint pain were 7.93±1.21, 3.38±1.59, 4.10±2.30, 4.90±1.88, and 5.80±1.71 at pre-procedure and at 1, 3, 6 and 12 months post-procedure. The mean ± SD values for Oxford Knee Score [OKS] [12–60] were 40.87±7.66, 23.90±5.60, 25.93±5.48, 27.93 ± 5.48, and 31.43±5.62 at pre-procedure and at 1, 3, 6 and 12 months post-procedure. One-way repeated measures of ANOVA test showed a significant decrease in VAS and OKS scores between pre and post-procedure at 1, 3, 6 and 12 months [p <0.001]. Conclusion: Radiofrequency thermocoagulation of genicular nerves provides significant pain relief and functional improvement in advanced knee joint osteoarthritis patients for a duration of one year.

Keywords

• radiofrequency ablation
• local anaesthetic block
• knee pain
• ultrasound guided
• fluoroscope guided