Painful Knee Osteoarthritis and Radiofrequency Neurotomy of Genicular Nerves

Purpose of the review Knee osteoarthritis is a progressive degenerative condition that affects quality of life due to chronic pain, decreased functional capacity, and insomnia. Although the commonly known principles in pain management are conservative approaches, injections, and surgery, the destruction of the genicular nerve, which provides sensory innervation from the knee joint, is one of the current approaches. In the method developed for this purpose, sensory denervation of the joint occurs by transmitting radiofrequency (RF) energy to the genicular nerves, causing tissue heating and neural denaturation, thus reducing nociceptive signal transmission. Recent findings Although the results may vary depending on the RF modality applied, the selected imaging guidance, the electrode diameter used, the duration of the procedure, and the temperature, genicular radiofrequency thermocoagulation (RFT) is an effective and safe method for painful knee osteoarthritis and ongoing painful knees after total knee arthroplasty with minor localized complications. Summary Genicular nerve RFT has been reported as an effective and safe option in cases where pain control cannot be achieved despite conventional and surgical treatments. The evidence is sufficient to show the benefits of RFT in the treatment of knee pain, and all 3 RF procedures are known to be similarly effective and safe.