Patient-Reported Outcomes Following Two-Tined Three-Site Conventional Radiofrequency Ablation of Genicular Nerves for Chronic Knee Pain

Background: Genicular nerve radiofrequency ablation (GNRFA) has emerged as an effective therapy for chronic knee pain.Although some studies have evaluated its effectiveness, there is limited real-world data on the long-term patient-reported outcome (PRO) data for GNRFAs.Objective: This study aimed to evaluate PROs following conventional GNRFAs performed using two-tined electrodes and the classical three-site technique targeting the superior medial, superior lateral, and inferior medial genicular nerves.Methods: We performed a retrospective chart review to gather data from consecutive GNRFAs at an academic medical center from 2016 to 2023.Inclusion criteria were all adult patients who received a conventional GNRFA performed using the classical three-site technique using two-tined electrodes.All included subjects were confirmed to have a positive diagnostic response (≥50% Numeric Rating Scale (NRS) reduction) to a previous genicular nerve block.Primary outcomes were NRS pain scores, Patient Reported Outcomes Measurement Information System (PROMIS) Global Health, and Patient Health Questionnaire-9 (PHQ-9).Results: A total of 31 patients underwent 38 GNRFAs.Relative to the pre-procedure baseline, the average NRS reduction post-procedurally was -3.17 during 0-3 months (p<0.0001),-1.31 during 3-6 months (p<0.05), and -1.92 during 6-12 months (p<0.05).Half of all patients maintained pain relief (NRS reduction greater than or equal to a minimal clinically important difference (MCID) of -2.0) for 11.17 months (95% CI: 7.29, 13.40).Although there was a positive trend for improvement in the quality-of-life measures, no statistically significant post-procedure improvement or worsening was observed during all time periods for PROMIS Physical Health, PROMIS Mental Health, and PHQ-9.Lastly, a history of depression was associated with treatment failure.Conclusion: In this real-world cohort, conventional GNRFA using the classical three-site technique demonstrated robust short-term pain reduction, and at least half of the cohort maintained clinically meaningful pain improvements for 11 months.For chronic knee pain, GNRFA is a reasonable therapeutic option in appropriately selected patients.