Is Cooled Radiofrequency Genicular Nerve Block and Ablation a Viable Option for the Treatment of Knee Osteoarthritis?

Authors

Andrew G. Carlone, University of KentuckyFollow
Olivia F. Grothaus, University of Kentucky
Cale A. Jacobs, University of KentuckyFollow
Stephen T. Duncan, University of KentuckyFollow

Abstract

Background

The purpose of this study was to determine demographic and psychosocial factors that influence the effectiveness of cooled radiofrequency genicular nerve ablation (C-RFA) and block in patients with chronic knee pain secondary to osteoarthritis (OA).

Methods

A retrospective review was completed including patients with knee OA who underwent genicular nerve ablation or block or both. Patient information collected included opioid use, psychological comorbidities, smoking history, body mass index, and medical comorbidities. Success was defined using the Osteoarthritis Research Society International criterion of greater than or equal to 50% reported pain relief from the procedure. Patients without a diagnosis of knee OA and patients with ipsilateral total knee arthroplasty were excluded. Patient factors were compared between (1) those that did or did not respond to the initial block and (2) those that did or did not respond to C-RFA.

Results

Of the 176 subjects that underwent genicular nerve block, 31.8% failed to respond to the procedure. Subjects that failed the initial block were significantly more likely to have psychological comorbidities, smoking history, and diabetes. Of the subjects that proceeded to genicular nerve ablation, 53.7% reported less than 50% pain relief, and 46.3% reported pain relief greater than or equal to 50% at the first follow-up visit. While the presence of psychological comorbidities, smoking, and diabetes were associated with first-stage block failures, these patient factors were not associated with second-stage ablation failures.

Conclusions

C-RFA may be an effective adjunct therapy as part of a multimodal pain regimen; however, individual patient characteristics must be considered.

Document Type

Article

Publication Date

2-8-2021

Notes/Citation Information

Published in Arthroplasty Today, v. 7.

© 2020 The Authors

This is an open access article under the CC BY-NC-ND license (https://creativecommons.org/ licenses/by-nc-nd/4.0/).

Digital Object Identifier (DOI)

https://doi.org/10.1016/j.artd.2020.12.003

Repository Citation

Carlone, Andrew G.; Grothaus, Olivia F.; Jacobs, Cale A.; and Duncan, Stephen T., "Is Cooled Radiofrequency Genicular Nerve Block and Ablation a Viable Option for the Treatment of Knee Osteoarthritis?" (2021). Orthopaedic Surgery and Sports Medicine Faculty Publications. 27.
https://uknowledge.uky.edu/orthopaedicsurgery_facpub/27