Session Information
Session Title: Research Spotlight: Pain and Spine Medicine
Session Time: None. Available on demand.
Disclosures: Alexandra E. Fogarty, MD: No financial relationships or conflicts of interest
Objective: Chronic knee pain secondary to osteoarthritis (OA) is a debilitating condition. Genicular nerve radiofrequency ablation (RFA) has emerged as an technique for the treatment of chronic knee pain. The objective was to determine the long-term effectiveness of fluoroscopically guided genicular nerve radiofrequency ablation (RFA) in adults with chronic knee pain due to osteoarthritis, when compared to sham, placebo, active standard of care treatment, or none.
Design: Systematic reviewSetting : Medline database searchParticipants : Adults 18 years of age or older with chronic knee pain due to osteoarthritis
Interventions: Fluoroscopically guided genicular nerve radiofrequency ablation (RFA)
Main Outcome Measures: Primary outcome measure was the improvement in patient-reported pain on the numeric rating scale (NRS) or visual analogue sale (VAS) after six months. Secondary outcomes included Oxford Knee Score (OKS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Two reviewers independently assessed publications before October 10, 2020. The Cochrane Risk of Bias Tool and Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) system evaluated risk of bias and evidence quality.
Results: A total of 121 records were screened, and 6 studies (from 9 publications) were included. Six-month success rates for ≥50% pain relief after RFA ranged from 49-74%. When compared to intraarticular steroid injection (IAS), the probability of success was 4.5 times higher for RFA (RR= 4.58 [95% CI 2.61, 8.04]). When RFA was compared to hyaluronic acid injection (HA), the probability of treatment success was 1.8 times higher (RR= 1.88 [95% CI 1.38, 2.57]). In addition, group mean OKS and WOMAC scores improved in participants treated with genicular RFA, as compared to IAS and HA.Conclusions: Per GRADE criteria, there is moderate quality evidence to support consistent improvement in pain and function in patients with chronic pain due to knee osteoarthritis who were treated with genicular nerve RFA at 6 months, compared to IAS and HA injections.
Level of Evidence: Level I
To cite this abstract in AMA style:
Fogarty AE, McCormick Z, Conger A, Burnham TR, Kuo KT, Tate Q, Sperry BP, Cheney CW, Cushman D. The Effectiveness of Fluoroscopically Guided Genicular Nerve Radiofrequency Ablation for the Treatment of Chronic Knee Pain Due to Osteoarthritis: A Systematic Review [abstract]. PM R. 2021; 13(S1)(suppl 1). https://pmrjabstracts.org/abstract/the-effectiveness-of-fluoroscopically-guided-genicular-nerve-radiofrequency-ablation-for-the-treatment-of-chronic-knee-pain-due-to-osteoarthritis-a-systematic-review/. Accessed May 15, 2025.« Back to AAPM&R Annual Assembly 2021
PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/the-effectiveness-of-fluoroscopically-guided-genicular-nerve-radiofrequency-ablation-for-the-treatment-of-chronic-knee-pain-due-to-osteoarthritis-a-systematic-review/