Comparing the Safety and Effectiveness of Radiofrequency Thermocoagulation on Genicular Nerves, Intraarticular Pulsed Radiofrequency with Steroid Injection in the Pain Management of Knee Osteoarthritis

Abstract:
Background and Aim: Knee osteoarthritis (KOA) leads to considerable morbidity. The current study aimed to assess radiofrequency thermocoagulation on the genicular nerve or intraarticular pulsed radiofrequency compared to the intraarticular steroid injection in KOA treatments.
Patients and Methods: A total of 90 patients with grade-2 or more KOA were involved in the work and were allocated to one of the following groups: Radiofrequency thermocoagulation (RFT) on the genicular nerve (RFTGN group), intraarticular pulsed radiofrequency (IAPRF group), or intraarticular steroid injection (IAS group). Each group had 30 patients. The following scores, Oxford Knee Score (OKS), numeric rating scale (NRS), and Global Perceived Effect (GPE), were assessed at 1 week and 1, 3, 6, and 9 months after the intervention.
Results: The majority of participants were females. One of the main findings in the present work was that IAS may mitigate severe knee joint discomfort and enhance the functioning of the joint in the shortest period. Another finding in the current study was that the prolonged analgesic benefits of both RFTGN and IAPRF were apparent, with the RFTGN group demonstrating substantially superior long-term enhancement in knee joint function compared to the IAPRF and IAS groups. No statistically significant variance in patient satisfaction was seen across the three groups one month post-treatment. Nonetheless, the GPE in the RFTGN and IAPRF groups was markedly elevated, in contrast to the IAS group at 3 and 6 months post-treatment. We noticed that the rate of pain relief was better in the 1^st and 3^rd, but low-rate pain relief was noticed starting in the 6^th month.
Conclusion: RFTGN and IAPRF are efficacious modalities for managing symptomatic KOA. Both procedures are simple to execute and have effective analgesic properties without significant problems. Future studies on many patients are warranted to draw firm conclusions.