Genicular Nerve Ablation: A Systematic Review Of Procedure Outcomes For Chronic Knee Pain

Background: Chronic pain caused by knee osteoarthritis is becoming more common among the elderly. Furthermore, patients who would otherwise benefit from total joint arthroplasty are not candidates for surgery due to increasingly high rates of obesity and diabetes. Genicular nerve ablation has become an attractive alternative to arthroplasty in these patients. This systematic review sought to assess the effectiveness and safety of genicular nerve ablation. Methods: A literature search of PubMed, Medline, clinicaltrials.gov, and Google Scholar was conducted for studies performing genicular nerve ablation with radiofrequency. Clinical and patient-centric outcomes were obtained. Results: Eleven studies and 194 knees were included in this analysis. Our review revealed that visual analog pain scores decreased from an average score of 8/10 to 1.9/10, 2.3/10, 2/10, and 4/10 at 3, 6, and 12 mo after genicular ablation, respectively. Additionally, Oxford Knee Scores and scores on the Western Ontario and McMaster Universities Arthritis Index showed improvements that were sustained at least up to 12 wk and 1 yr, respectively. There were very few procedural complications. Conclusions: Genicular nerve ablation with radiofrequency has demonstrated favorable outcomes with low complication rates.