Long-term Efficacy of Genicular Nerve Ablation for Chronic Osteoarthritic Knee Pain: A Prospective Observational Longitudinal Study

Thanawut Jitsinthunun; Pramote Euasobhon; Amornrat Suttijanuwat; Suratsawadee Wangnamthip; Pranee Rushatamukayanunt; Sukunya Jirachaipitak; Nantthasorn Zinboonyahgoon; Mohd Suhaimi Tajudin; Rapeepat Narkbunnum; Werasak Sutipornpalangkul

doi:10.33192/smj.v75i6.261692

Authors

Thanawut Jitsinthunun Department of Anesthesiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok
Pramote Euasobhon Department of Anesthesiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok
Amornrat Suttijanuwat Department of Anesthesiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok / Department of Anesthesia, Chaophrayayommarat Hospital, Suphanburi
Suratsawadee Wangnamthip Department of Anesthesiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok
Pranee Rushatamukayanunt Department of Anesthesiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok
Sukunya Jirachaipitak Department of Anesthesiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok
Nantthasorn Zinboonyahgoon Department of Anesthesiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok
Mohd Suhaimi Tajudin Anesthesiology and Critical care Department, Selayang Hospital, Selangor, Malaysia
Rapeepat Narkbunnum Department of Orthopedic Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok
Werasak Sutipornpalangkul Department of Orthopedic Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok

DOI:

https://doi.org/10.33192/smj.v75i6.261692

Keywords:

knee pain, joints, osteoarthritis, radiofrequency ablation, genicular nerve, conservative treatment

Abstract

Objective: When patients with chronic osteoarthritis (OA) knee pain do not respond to conservative treatment and are not suitable for knee arthroplasty, radiofrequency ablation (RFA) of the genicular nerve is probably an alternative treatment. This study aimed to evaluate the efficacy and safety of genicular nerve ablation in severe osteoarthritic knee pain patients.

Materials and Methods: Patients with severe chronic OA knee pain were recruited and performed a genicular nerve block (GNB). The patients’ demographic data, numerical rating scale (NRS) at rest and on movement, Thai Oxford knee score (Thai OKS), Thai knee injury and osteoarthritis outcome score physical function short form (Thai KOOS-PS), timed up and go test, brief pain inventory, fall evaluation, and EuroQol 5D-5L were recorded. For the positive block patients (≥50% pain relief for 24 hours), genicular nerve RFA was performed under fluoroscopic or ultrasound guidance. All patients were followed up at the 1^st, 3^rd, 6^th, 9^th and 12^th months.

Results: 21 patients were included in the study, but only 17 were completely followed up for 12 months. At the 12^th month, genicular nerve RFA reduced the mean NRS on movement from 7.9±1.6 to 4.0±2.6 (p=0.005), improved knee function (Thai OKS from 18.8±5.3 to 28.5±10.1; p=0.006), but did not significantly improve quality of life (EuroQol-5D-5L from 0.43±0.20 to 0.69±0.33; p=0.130). No adverse events were observed.

Conclusion: Genicular nerve radiofrequency ablation in severe chronic OA knee patients demonstrated significant pain relief and functional improvement for up to 12 months without serious adverse events.

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