Genicular nerve cooled radiofrequency ablation may effectively relieve chronic knee pain associated with osteoarthritis and improve function for up to 6 months, according to research presented at the American Academy of Pain Medicine 2018 Annual Meeting, held April 25 to 29, 2018, in Vancouver, British Columbia, Canada. In addition, a diagnostic genicular nerve block may not represent an accurate predictor of outcomes from this procedure.

The investigators sought to evaluate the predictive value of a diagnostic genicular block for outcomes of a subsequent cooled radiofrequency ablation of the genicular nerve for osteoarthritis-associated knee pain. For this study, patients with chronic knee pain were randomly assigned to receive a diagnostic genicular nerve block or no block (25 patients, 35 knees) before cooled radiofrequency ablation.

The ablation procedure was carried out only in patients who experienced ≥50% pain reduction from the diagnostic nerve block (29 patients, 36 knees). The study’s primary outcome was ≥50% pain relief at the 6-month follow-up.

Pain relief ≥50% at 5 months after the ablation procedure was observed for 15 (41.7%) of 36 knees of study participants who received the diagnostic genicular nerve block, and for 15 (42.9%) of 35 knees in patients who had not received the block (P =.92).

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A 15-point reduction in the 24-item Western Ontario and McMaster Universities Osteoarthritis index was observed for 44.8% of all study participants, and a global perception of “improved” or “very much improved” change was reported by 38.6% of patients at 6-month follow-up.

“This study demonstrated clinically meaningful improvements in pain and physical function up to 6 months following [cooled radiofrequency ablation],” concluded the study authors. “A diagnostic genicular nerve block with a threshold of ≥ 50% pain relief did not improve the rate of treatment success,” they added.

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Reference

McCormick Z, Reddy R, Korn M. Do diagnostic genicular nerve blocks predict treatment outcomes of cooled radiofrequency ablation in patients with chronic knee pain from osteoarthritis? A prospective randomized trial. Presented at: American Academy of Pain Medicine 2018 Annual Meeting; April 25-29, 2018; Vancouver, British Columbia, Canada. Abstract 144.