Long-term efficacy of genicular nerve radiofrequency ablation in patients with advanced knee osteoarthritis: A retrospective cohort study.

Abstract

Objective: Conventional treatments for advanced knee osteoarthritis (OA) are often insufficient, and surgery is not always feasible. This retrospective cohort study aimed to evaluate changes in pain, function, and safety over 12 months following ultrasound-guided genicular nerve radiofrequency ablation (GNRFA).

Methods: We included 44 patients with chronic knee pain unresponsive to conservative treatments for at least 3 months. All patients underwent US-guided radiofrequency ablation of the superomedial, superolateral, and inferomedial genicular nerves. Pain numeric rating scale (NRS) and functional status Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores were assessed at baseline, and routinely at 1, 6, and 12 months post-procedure.

Results: Compared to baseline, mean NRS and WOMAC scores decreased significantly at all follow-up points (p<0.001). Based on a ≥50% pain reduction threshold (clinical success), 81.8% of patients achieved success at 1 month, and 75.0% maintained it at 6 months. By 12 months, this rate declined to 11.4%. No statistically significant differences in outcomes were observed between radiological grades. A strong positive correlation between NRS and WOMAC scores was observed across all follow-up times. No serious adverse events were reported.

Conclusion: US-guided GNRFA was associated with improvements in pain and function, which were most pronounced within the first 6 months in patients with advanced knee OA. However, the marked decline in responder rates at 12 months suggests reduced durability beyond 6 months. These findings suggest that GNRFA may serve as a medium-term management option rather than a permanent solution, and that re-evaluation may be appropriate in patients with recurrent symptoms.