Clinical Effectiveness, Disability, and Outcomes of Genicular Nerve Ablation for Chronic Knee Pain.

BACKGROUND: Chronic knee (CK) pain has various underlying etiologies with several available therapeutic options that differ in effectiveness, duration, and complication rate. For the past decade, a minimally invasive ablation relying upon genicular radiofrequency has been gaining popularity as a treatment for the condition. To date, however, the literature contains only limited data supporting the effectiveness of this procedure, leading to insurance companies labeling it as "experimental" and denying claims. Benefits described include reduced adverse outcomes and complications, quicker recovery and longer duration of analgesia, and broader scope of applicability when compared to other, traditional treatments.

OBJECTIVES: The present investigation focused on genicular radiofrequency ablation (GRFA) and its outcomes, including disability (e.g., stiffness, physical function), pain, and improvement in patients' quality of life.

STUDY DESIGN: This retrospective, single-center study was conducted to evaluate the safety and effectiveness of GRFAs, plus their associated radiofrequency generators and electrode systems. The equipment consisted of the MultiGen® 2 Radiofrequency Generator (Stryker Corporation) and the RFA Solutions Generator System (Avanos Medical, Inc.).

METHODS: Selected patient age ranged between 26 and 92 years, with a mean age of 56.5 years. Thirty-four (34) individuals were enrolled at LSU Health Shreveport, which was the sole investigational site, between March 2021 and 2025. The Stryker SERFAS Energy Platform (Stryker Corporation) was the primary radiofrequency generator selected for genicular ablation (61.9%), with the Avanos RFA Solutions Generator System (Avanos Medical, Inc.) selected for the remaining cases. As for the outcome measures, scores on the visual analog scale (VAS), disability changes measured on the Western Ontario and McMaster Universities Arthritis Index (WOMAC), adverse outcomes, quality of improvement, and ratings recorded in the Quality of Life subsection of the Knee Injury and Osteoarthritis Outcome Score (KOOS) were compared after GRFA.

RESULTS: Mean VAS scores for CK pain intensity decreased significantly, dropping by 3.1 cm from a baseline score of 9.0 cm by the specified end (March 18th, 2025). Furthermore, 66.7% of the patients experienced a 20% or greater improvement in pain, 33.3% of the patients experienced a 40% or greater improvement in pain, and 19.1% of the patients experienced a 60% or greater improvement in pain. Zero (0) procedure-related adverse events or intra- or post-procedural complications occurred during the investigation.

LIMITATIONS: The study was retrospective and had no sham operation to determine placebo response. The relatively small sample size (34 total ablations, 21 patients) could have limited the generalizability of the results. Furthermore, the withdrawal rate was 38%, thereby limiting the certainty of the treatment's long-term duration. Results should be considered hypothesis-generating, not confirmatory, but they align well with the growing body of corroborating literature.

CONCLUSIONS: The results of this study substantially reinforce GRFA as a safe, effective, and minimally invasive treatment option for patients experiencing CK pain over a 6-month period.