scholarly journals A Review of Long-Term Pain Relief after Genicular Nerve Radiofrequency Ablation in Chronic Knee Osteoarthritis

2017 ◽  
Vol 3 (20;3) ◽  
pp. E437-E444 ◽  
Author(s):  
Ferdinand Iannaccone
Keyword(s):  
Radiofrequency Ablation ◽  
Pain Relief ◽  
Pain Score ◽  
Knee Pain ◽  
Study Design ◽  
Chart Review ◽  
Health Sciences ◽  
Chronic Knee Pain

Background: Studies of radiofrequency ablation (RFA) of genicular nerves have reportedly significantly decreased pain up to 3 months post ablation, but no longer term effects have been reported. We performed an analysis of long-term pain relief of 31 RFA procedures of the genicular nerves to analyze the degree of pain relief past 3 months, culminating at 6 months. Objective: To evaluate the long term efficacy of genicular nerve ablation for management of chronic knee pain due to osteoarthritis. Study Design: Chart review and study design was approved by Newark Health Sciences IRB. Chart review and follow-up was performed on all patients who underwent genicular nerve RFA during the period of February 2014 through August of 2015. During this inclusion period 41 genicular nerve RFAs were performed on 31 patients, 5 patients received RFA procedure in both knees. Patient follow-up was performed via telephone interview or in-office visit at least 3 months and 6 months post RFA. Settings: Procedures were performed in Medical Special Procedures at University Hospital in Newark, NJ, and the Pain Management Center at Overlook Medical Arts Center in Summit, NJ. Methods: Chart review and study design was approved by Newark Health Sciences Institutional Review Board. Chart review was performed from February 2014 and continued through August 2015. Patient follow-up was conducted at 3 and at least 6 months post treatment to gauge degree of pain relief (0 – none, 100% – complete), their current day’s pain score, other treatment modalities tried before RFA, and the medications used. Patients were asked to quantify their satisfaction with procedure length, pre-procedure anxiety, complications, and if they would recommend this procedure to others. Primary and secondary goals were the duration of pain relief after RFA, the quality of pain relief, and the efficacy of our approach for RFA of genicular nerves versus prior published techniques. Results: At 3 month follow-up, the average pain relief was 67% improvement from baseline knee pain, 0% being no relief and 100% being complete relief, and average 0 – 10 pain score was 2.9. At 6 month follow-up, of those who described pain relief at 3 months, 95% still described pain relief. This group’s average percent pain relief was 64% and average day’s 0 – 10 pain score 3.3. Limitations: Our study included a retrospective component in chart review followed by prospective follow-up, only 76% of patients were able to participate in the interview process. Furthermore, some patients suffered from other chronic pain ailments, most commonly chronic back pain, which at times disturbed the patient’s ability to focus on solely knee pain. Conclusions: Based on patient interviews and data collection, RFA of genicular nerves can supply on average greater than 60% pain relief in our patient population for as long as 6 months. Key words: Osteoarthritis, knee osteoarthritis, chronic knee pain, radiofrequency ablation, nerve ablation, genicular nerves, long-term pain relief

scholarly journals The Long Term Effectiveness of Genicular Nerve Blocks for Chronic Knee Pain: A Retrospective Study

2018 ◽  
pp. 75-77
Author(s):  
Laura Anne Lynem
Keyword(s):  
Retrospective Study ◽  
Radiofrequency Ablation ◽  
Pain Relief ◽  
Knee Pain ◽  
Nerve Block ◽  
Nerve Blocks ◽  
Chronic Knee Pain ◽  
Post Procedure

Chronic knee pain is a leading cause of chronic disability and its symptoms have a profound impact on the lives of those suffering from it. Current treatment modalities for chronic knee pain include pharmacologic and nonpharmacologic interventions. Genicular nerve blocks are a new therapeutic alternative that have been shown to relieve chronic knee pain and may provide significant relief in patients who are either poor surgical candidates or are unwilling to accept the risks associated with surgery. Genicular nerve blocks may provide long term pain relief for chronic knee pain and radiofrequency ablation (RFA) may not be necessary. This Institutional Review Board (IRB) approved retrospective study conducted at a single center university hospital involved 44 patients aged 43 to 87 who received genicular nerve blocks for chronic knee pain. The primary purpose of this study was to determine if genicular nerve blocks provide effective long term pain relief for patients with chronic knee pain. The numeric rating scale was used to measure the patient’s knee pain at baseline, 30, 90, and 120 days post procedure. Patients experienced a mean pain level of 7.43 out of 10 before the genicular nerve block and 4.02 afterward representing an average improvement of 42.6% in pain relief overall post procedure follow-up. A t-test revealed a statistically significant difference between the mean pain score before and after the blocks (t = 8.534, P < 0.01). Overall, the patients experienced significant pain relief of an average of 111.9 days resulting in an average of 42.6 percent pain relief post procedure follow-up. Out of the 44 patients, 15 (34.1%) underwent a RFA after receiving a genicular nerve block procedure to further manage their chronic knee pain symptoms. In conclusion, we have found statistically significant evidence that genicular nerve blocks provide effective long-term pain relief for patients with chronic knee pain. Therefore, for patients who are not surgical candidates, genicular nerve blocks represent a viable alternative treatment for knee pain. Key words: Genicular nerve blocks, chronic knee pain, genicular nerves, genicular nerve radiofrequency ablation

Evaluating predictors of pain reduction after genicular nerve radiofrequency ablation for chronic knee pain

2021 ◽  
Author(s):  
Annie Philip ◽  
Mark Williams ◽  
Jenae Davis ◽  
Avinash Beeram ◽  
Changyong Feng ◽  
...  
Keyword(s):  
Radiofrequency Ablation ◽  
Pain Relief ◽  
Knee Pain ◽  
Chart Review ◽  
Retrospective Chart Review ◽  
Pain Reduction ◽  
Nerve Blocks ◽  
Chronic Knee Pain ◽  
Pain Outcomes ◽  
Pain Improvement

Aim: Radiofrequency ablation (RFA) of genicular nerves can treat refractory chronic knee pain. This study evaluated association between patient and procedural characteristics and pain improvement after genicular nerve RFA. Materials & methods: A retrospective chart review. Data were extracted from patients who underwent thermal or cooled RFA of the knee. Results: A total of 124 patients were included. 81% of patients reported ≥75% pain relief after diagnostic nerve blocks. 35% reported ≥50% pain reduction from the RFA. Predictors of improved pain outcomes included higher baseline pain, no depression and thermal (vs cooled) RFA. Conclusion: Identifying patients who may benefit the most from genicular RFA is still not clear. Pain reduction differences between patients with and without depression and RFA type deserves further exploration.

scholarly journals Long-Term Retrospective Assessment of Clinical Efficacy of Radiofrequency Ablation of the Knee Using a Cooled Radiofrequency System

2019 ◽  
Vol 5 (22;5) ◽  
pp. 489-489
Author(s):  
Leonardo Kapural
Keyword(s):  
Chronic Pain ◽  
Radiofrequency Ablation ◽  
Pain Relief ◽  
Knee Pain ◽  
Controlled Trial ◽  
Real Life ◽  
Clinical Effectiveness ◽  
Opioid Use ◽  
Chronic Knee Pain

Background: Cooled radiofrequency ablation (CRFA) in a randomized, prospective study demonstrated significantly greater improvements in pain, functional, and global outcome measures. Objectives: This large, real-life, retrospective study evaluated the long-term effectiveness of CRFA in the general chronic knee pain population. Study Design: Retrospective electronic chart review. Setting: Outpatient private practice. Methods: After institutional review board approval, we reviewed data of 275 consecutive patients who had undergone a geniculate nerve block at a single-site pain practice between July 1, 2014 and July 1, 2017. A total of 44 patients had a negative response to the geniculate block, and 11 patients had long-term pain relief from the block and declined CRFA. Eight patients underwent knee surgery after the block, and 7 never followed up for further treatment. Finally, 205 patients had undergone CRFA, and 183 (89%) of them returned to provide data. Results: The average age of the 183 patients was 61 (28-95) years, body mass index 34 (18.5- 57), and there were 105 women and 78 men. A total of 137 patients had unilateral knee pain, whereas 46 patients had bilateral knee pain. Eighty percent (146/183) reported at least one or more additional sources of chronic pain (back, shoulder, and others). The average opioid use at baseline was 50 mg morphine sulfate equivalents (median 30 mg). The average baseline pain scores were 8.5, which decreased to 2.2 after the geniculate local anesthetic block, and to 4.2 after CRFA. A total of 65% of the patients claimed > 50% pain relief, whereas 77% had 2 or more Visual Analog Scale points decrease, and 26 (14%) patients reported no pain at all after CRFA. The mean duration of > 50% pain relief after CRFA was 12.5 months (range 0-35 months). There was no significant decrease of opioid use. Patients who underwent a repeated procedure (n = 43) achieved a similar pain relief (P = 0.402). We could not find a statistical difference in geniculate CRFA outcomes between the group who had total knee arthroplasty (TKA; n = 21) and maintained chronic knee pain and patients who had no prior surgery (P = 0.542). Limitations: Retrospective nature of the study. Conclusions: This study demonstrates the clinical effectiveness of CRFA in the treatment of chronic knee pain from osteoarthritis, and even in those patients who maintained chronic knee pain after TKA. Our real-life data seems to agree with data previously published in a randomized controlled trial, despite the fact that this was quite a heterogenous patient population with various sources of chronic pain. Key words: Radiofrequency ablation, chronic knee pain, knee osteoarthritis

Efficacy of Internal Neurolysis for Trigeminal Neuralgia without Vascular Compression

2021 ◽  
Author(s):  
Ming-Wu Li ◽  
Xiao-feng Jiang ◽  
Chaoshi Niu
Keyword(s):  
Pain Relief ◽  
Trigeminal Neuralgia ◽  
Chart Review ◽  
Vascular Compression ◽  
Internal Neurolysis ◽  
Facial Numbness ◽  
Relief Rate

Abstract Background and Objective Trigeminal neuralgia is a common neurologic disease that seriously impacts a patient's quality of life. We retrospectively investigated the efficacy and safety of internal neurolysis (nerve combing) for trigeminal neuralgia without vascular compression. Patients and Methods This study was a retrospective review of all patients with trigeminal neuralgia who were admitted between January 2014 and February 2019. A subgroup of 36 patients had no vascular compression at surgery and underwent internal neurolysis. Chart review and postoperative follow-up were performed to assess the overall outcomes of internal neurolysis. Results Thirty-six patients were identified, with a mean age of 44.89 ± 7.90 (rang: 31–65) years and a disease duration of 5.19 ± 2.61 years. The immediate postoperative pain relief (Barrow Neurological Institute [BNI] pain score of I or II) rate was 100%. The medium- to long-term pain relief rate was 91.7%. Three patients experienced recurrence. Facial numbness was the primary postoperative complication. Four patients with a score of III on the BNI numbness scale immediately after surgery had marked improvement at 6 months. No serious complications occurred. Conclusion Internal neurolysis is a safe and effective treatment for trigeminal neuralgia without vascular compression or clear responsible vessels.

scholarly journals Effectiveness of Genicular Nerve Cooled Radiofrequency Ablation on Chronic Knee Osteoarthritis Pain

2019 ◽  
pp. 83-90
Author(s):  
Jonathan Carrier
Keyword(s):  
Statistical Analysis ◽  
Radiofrequency Ablation ◽  
Knee Osteoarthritis ◽  
Knee Pain ◽  
Primary Outcome ◽  
Time Points ◽  
Chronic Knee Pain ◽  
Study Population ◽  
The Mean

Background: Outside of an invasive total knee arthroplasty, the available therapies for the treatment of pain secondary to knee osteoarthritis (OA) provide marginal and short-lived symptomatic relief. Genicular nerve radiofrequency ablation (RFA) serves as an alternative treatment modality for OA-associated knee pain and disability. Objectives: To quantify the effectiveness of cooled radiofrequency ablation (C-RFA) of the genicular nerves for chronic knee pain secondary to OA. Study Design: Retrospective chart review performed using Redcap, implementing current procedural terminology codes. Setting: An academic pain management center. Methods: Study population included patients treated with C-RFA from April 2015 through June 2017. Numeric Rating Scale (NRS) data were analyzed at 3 time points: 2 weeks, 4-6 weeks, and 7-33 weeks post-RFA (extended follow-up). Primary outcome for statistical analysis was NRS and the change in NRS from baseline at each of the 3 predetermined time points. Differences between the change in NRS and the number of diagnostic blocks performed (1 vs. 2) was evaluated. Correlation between the change in NRS and patient body mass index (BMI) was calculated. Results: Pre-RFA average NRS scores were available for 47 knees from 31 individuals, which were included in the analysis. The mean NRS score decreased by 50% at 2 weeks (n = 33; P < 0.001), 55% at 4-6 weeks (n = 18; P < 0.001), and 26% at 7-33 weeks (n = 18; P = 0.009). Eight patients (12 knees) provided specific data on the total duration of relief following RFA. The mean duration was 39 weeks or approximately 9 months. There were no statistically significant differences between groups receiving 1 versus 2 diagnostic blocks at 2 weeks or 4-6 weeks post- RFA. At 7-33 weeks, those who received 1 block had a decrease in NRS of –3.1, whereas those who received 2 blocks had an increase in NRS of +0.1 (P = 0.008). There was no correlation identified between BMI and change in NRS at any time point. Limitations: This study’s retrospective design inherently leads to a higher risk of selection bias. The sample size was relatively small as a high percentage of patients were lost to follow-up. The primary outcome measure for this study was the change in mean NRS pain score, and the mean of ordinal data with a nonnormal distribution lacks validity in statistical analysis. Conclusions: In this study population, C-RFA of the genicular nerves lead to 50% or greater pain relief at 2 weeks and 4-6 weeks postintervention. A 26% pain relief was achieved at 7-33 weeks, but this did not meet the established minimal clinically important difference cutoff. Two diagnostic genicular nerve blocks did not improve the rate of treatment success when compared to a single diagnostic block. BMI does not appear to correlate with outcomes. Key words: Genicular radiofrequency ablation, genicular RFA, cooled radiofrequency ablation, chronic knee pain, knee osteoarthritis

scholarly journals Conventional Thermal versus Water-Cooled Genicular Nerve Radiofrequency Lesioning: A Retrospective Chart Review

2019 ◽  
pp. 16-172
Author(s):  
Cristina Shea
Keyword(s):  
Knee Pain ◽  
Chart Review ◽  
Academic Medical Center ◽  
Retrospective Chart Review ◽  
Pain Clinic ◽  
Fisher Exact Test ◽  
Pain Scores ◽  
Chronic Knee Pain ◽  
Significant Difference

Background: Genicular nerve radiofrequency lesioning (RFL) is an interventional approach to chronic knee pain. It is currently unknown whether conventional thermal RFL (CT-RFL) or watercooled RFL (WC-RFL) yields better outcomes. Objective: The objective of this research was to analyze and compare outcomes of genicular nerve conventional thermal radiofrequency lesioning (CT-RFL) vs water-cooled radiofrequency lesioning (WC-RFL) for the treatment of chronic knee pain. Study Design: We used retrospective chart review. Setting: The research took place in an outpatient pain clinic at a large academic medical center. Methods: Patients who participated in the study were those aged 18 and older who received genicular nerve RFL for chronic knee pain between January 1, 2014 and December 31, 2016. Random intercepts models were used to examine Visual Analog Scale (VAS) pain scores across the first year of follow-up, adjusting for age, gender, and prior history of knee surgery. Results: Overall, VAS scores were significantly reduced from baseline (mean = 6.66, standard deviation [SD] = 1.36) by 1.46 points during the first follow-up month (95% confidence interval [CI], 0.6-2.3, P = .001), 2.22 points during the second follow-up month (95% CI, 1.4-3.1, P = < .001), and 1.24 points during the sixth follow-up month (95% CI, 0.1-2.4, P = .035) but were not significantly reduced at other months during the one-year followup time period. There was no statistically significant difference in follow-up pain scores (mean difference = 0.73, 95% CI, -0.14-1.59, P = .116) or rates of complications (P = .10, 2-tailed Fisher exact test) between RFL types. Limitations: Study shortcomings include patient loss to follow-up, heterogeneity of CT-RFL techniques, and heterogeneity of study patients. Conclusions: Genicular RFL is a promising strategy for long-term management of treatment-resistant chronic knee pain. In this study, no significant difference in outcomes was detected between CT-RFL and WC-RFL techniques. Larger prospective studies are warranted to compare outcomes of these techniques and guide future care. Key words: Radiofrequency lesioning, knee pain, chronic pain, osteoarthritis, genicular, cooled radiofrequency lesioning, water-cooled radiofrequency lesioning, conventional radiofrequency lesioning

scholarly journals OUTCOMES FOLLOWING ACL RECONSTRUCTION USING PATELLAR TENDON VERSUS HAMSTRING TENDON AUTOGRAFT IN ADOLESCENT ATHLETES: AN AGE-MATCH, SEX-MATCHED, AND BODY MASS INDEX-MATCHED COHORT STUDY

2019 ◽  
Vol 7 (3_suppl) ◽  
pp. 2325967119S0007
Author(s):  
Benton E. Heyworth ◽  
Elizabeth S. Liotta ◽  
Peter D. Fabricant ◽  
Ashley J. Tisosky ◽  
Cameron Waites ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Propensity Score ◽  
Knee Pain ◽  
Anterior Knee Pain ◽  
Chart Review ◽  
Hamstring Tendon ◽  
Tendon Autograft ◽  
Anterior Knee

Background: Anterior cruciate ligament reconstruction (ACLR) remains one of the most commonly performed orthopaedic surgeries in adolescents and young adults. However, selection of the optimal graft for the individual patient remains controversial, considering multiple graft options, subtle technique differences, and wide-ranging bodies of evidence for each graft option in largely adult populations. However, multiple epidemiologic studies clearly demonstrate adolescents as the most greatly affected age-based sub-population, with the highest rates of re-tear and global morbidity, due to psychological and physical effects of long absences from athletic activity. Nevertheless, methodologically rigorous comparative studies specific to the adolescent athlete are largely absent from the literature. The purpose of the current study is to therefore investigate the outcomes of ACLR in adolescents receiving either patellar tendon/bone-tendon-bone (BTB) autograft (ACLR-BTB) or hamstring tendon autograft (ACLR-HS), using retrospective propensity score matching techniques to generate comparable cohorts. Methods: The study was designed as a retrospective chart review, with collection of cross-sectional data from a single pediatric tertiary care center over a thirteen year period (2003-2015). An initial cohort of patients, aged 13-19 years at time of primary ACLR-BTB or primary ACLR-HS by one of 5 surgeons, was identified through a comprehensive electronic medical record database query. Propensity score matching of ACLR-BTB and ACLR-HS subjects through a logistic regression model, with caliper restriction of 0.1 standard deviations, was then applied, based upon specific baseline characteristics that are frequently used by some surgeons to guide graft selection: age, sex, and body mass index (BMI). The resultant cohort of patients obtained a 1:2 (ACLR-BTB: ACLR-HS, 83 patients:186 patients) match. A chart review was performed to identify patient demographics, surgical data, and post-operative outcomes including graft rupture/re-tear and length of clinical follow-up. Patients were additionally contacted to obtain longer term sport participation and re-injury data that may have been investigated or addressed at outside institutions, as well as to obtain functional outcomes using region-specific questionnaires (Pedi-IKDC and HSS-Pedi FABS), which are validated for both this younger population and adult populations. Due to previous literature-based reports on greater anterior knee pain following ACLR-BTB, compared to ACL-HS, scores from the questions specific to knee pain or kneeling pain were extracted from the Pedi-IKDC results and analyzed to assess the potential influence of anterior knee pain on overall scores within this adolescent population. Results: At time of ACLR, the mean age and BMI of the matched ACLR-BTB patients were 17.1 years (sd: +/-1.14 years) and 25.8 (sd: +/-5.04), compared to 16.9 years (sd: +/- 1.38, p: 0.18) and 24.9 (sd: +/- 5.01, p: 0.18) for matched ACLR-HS patients, with similar male preponderance (ACLR-BTB: 77%, ACLR-HS: 72%, p: 0.47) and mean length of follow-up (ACLR-BTB: 42.9 months; ACLR-HS: 43.3 months). While mean Pedi-IKDC scores were slightly higher in the ACLR-BTB group (88.8; sd: +/-10.2, range: 56.5-100) than the ACLR-HS group (85.2; sd: +/- 16.1, range: 23.9-100), this difference was not statistically different (p: 0.50). When scores on questions regarding knee pain and kneeling difficulty were analyzed, no differences were seen between graft cohorts (ACLR-BTB: median knee pain score: 4, ACLR-HS: 4 p: 0.73; ACLR-BTB median kneeling difficulty score: 4, ACLR-HS: 4, p: 0.21). Activity level, based on the HSS-Pedi FABS score, was also similar (ACLR-BTB: 16, range: 3-29 vs. ACLR-HS: 17, range: 0-30; p: 0.96). Rates of ACL graft re-tear were not significantly different between groups, both when calculated based all possible follow-up methods (ACLR-BTB: 11%, ACLR-HS: 11%, p: 0.91), or when those patients responding to long-term follow up questionnaires were isolated (ACLR-BTB: 15%, ACLR-HS: 16%, p: 0.85). Conclusion/Significance: Despite previous studies, including large, multi-country registry-based analyses, demonstrating lower re-tear rates following ACLR-BTB than ACLR-HS, the current study, focused exclusively on adolescent cohorts matched for age, sex, and BMI, showed no difference in graft re-tear rates between the two cohorts at medium-term follow-up. Moreover, activity scores and functional knee outcome scores appear to be equivalent between these younger graft-based populations. In contrast to previous studies associating BTB autograft with greater long term anterior knee pain, adolescents appear to have equal degrees of knee pain or kneeling pain, regardless of graft choice, which may stem from greater healing and biologic remodeling capacity at graft harvest sites than adults or more modern techniques of patellar bone grafting and paratenon closure. Given the consistently high adolescent ACL re-tear rates in this and other studies, continued focus on ACL prevention programs and optimizing the timing and safety of return to play remains critical.

scholarly journals Comparative Effectiveness Review of Cooled Versus Pulsed Radiofrequency Ablation for the Treatment of Knee Osteoarthritis: A Systematic Review

2017 ◽  
Vol 3 (20;3) ◽  
pp. 155-171 ◽  
Author(s):  
Anita Gupta
Keyword(s):  
Systematic Review ◽  
Total Knee Arthroplasty ◽  
Radiofrequency Ablation ◽  
Knee Pain ◽  
Knee Arthroplasty ◽  
Strength Of Evidence ◽  
Chronic Knee Pain ◽  
Total Knee ◽  
Evidence Grading

Background: Patients suffering from osteoarthritis of the knee and patients post total knee arthroplasty often develop refractory, disabling chronic knee pain. Radiofrequency ablation, including conventional, pulsed, and cooled, has recently become more accepted as an interventional technique to manage chronic knee pain in patients who have failed conservative treatment or who are not suitable candidates for surgical treatment. Objective: This systematic review aimed to analyze published studies on radiofrequency ablation to provide an overview of the current knowledge regarding variations in procedures, nerve targets, adverse events, and temporal extent of clinical benefit. Study Design: A systematic review of published studies investigating conventional, pulsed, or cooled radiofrequency ablation in the setting of chronic knee pain. Methods: Medline, Google Scholar, and the Cochrane Central Register of Controlled Trials (CENTRAL) databases were reviewed for studies on radiofrequency ablation for patients with chronic knee pain through July 29, 2016. From the studies, the procedural details, outcomes after treatment, follow-up points, and complications were compiled and analyzed in this literature review. Included studies were analyzed for clinical relevance and strength of evidence was graded using either the NHLBI Quality assessment of controlled intervention studies or the NHLBI quality assessment for before-after (pre-post) studies with no control group. Results: Seventeen total publications were identified in the search, including articles investigating conventional, pulsed, or cooled radiofrequency ablation. These studies primarily targeted either the genicular nerves or used an intraarticular approach. Of the studies, 5 were small-sized randomized controlled trials, although one involved diathermy radiofrequency ablation. There were 8 retrospective or prospective case series and 4 case reports. Utilizing the strength of evidence grading, there is a low level of certainty to suggest a superior benefit between targeting the genicular nerve, an intraarticular approach, or targeting the larger nerves such as femoral and tibial nerves. Utilizing the strength of evidence grading, there is a low level of certainty in supporting the superiority of any specific RFA procedure modality. The majority of the studies report positive patient outcomes, but the inconsistent procedural methodology, inconsistent patient assessment measures, and small study sizes limit the applicability of any specific study to clinical practice. Limitations: While the wide search strategy included a variety of articles, broad conclusions and pooled data could not be obtained based on the studies analyzed. Conclusions: Overall, the studies showed promising results for the treatment of severe chronic knee pain by radiofrequency ablation at up to one year with minimal complications. Numerous studies, however, yielded concerns about procedural protocols, study quality, and patient follow-up. Radiofrequency ablation can offer substantial clinical and functional benefit to patients with chronic knee pain due to osteoarthritis or post total knee arthroplasty. Key words: Radiofrequency ablation, knee osteoarthritis, knee pain, genicular nerve, total knee arthroplasty (TKA), cooled radiofrequency ablation, pulsed radiofrequency ablation

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