According to the results of a study recently published in Regional Anesthesia and Pain Medicine, cooled radiofrequency ablation may provide greater pain relief compared with intraarticular steroid injection in patients with osteoarthritis-related chronic knee pain.
In this prospective clinical trial, participants with osteoarthritis-related knee pain lasting 6 months or more were randomly assigned to receive cooled radiofrequency ablation (Coolief system; n=76) or intraarticular steroid injection (n=75) in a single knee. Knee pain, analgesic use, and adverse events were compared between groups at 1, 3, and 6 months postintervention.
At all follow-up intervals, the mean Numeric Rating Scale score for knee pain was lower in the radiofrequency ablation group compared with the intraarticular steroid group. At 6-month follow-up, more patients who had received radiofrequency ablation vs intraarticular steroid injections had ≥50% reduction in pain score from baseline (74% vs 16%; P <.001).
A higher percentage of patients in the radiofrequency ablation group reported “no pain” at follow-up compared with the intraarticular steroid group (22% vs 4%; P <.002). At 6 months, the mean Oxford Knee Score and mean Global Perceived Effect were also significantly greater in the cooled radiofrequency ablation group compared with the intraarticular steroids group (P <.001 for both). Nonopioid drug use was significantly decreased in the radiofrequency ablation group compared with the steroid group (P =.02).
No treatment-related serious adverse events were reported in either group.
The study authors concluded that, “[cooled radiofrequency ablation] (Coolief) for genicular nerve ablation is superior to a single corticosteroid injection in osteoarthritic subjects for managing knee pain.”
Davis T, Loudermilk E, DePalma M, et al. Prospective, multicenter, randomized, crossover clinical trial comparing the safety and effectiveness of cooled radiofrequency ablation with corticosteroid injection in the management of knee pain from osteoarthritis [published online November 1, 2017]. Reg Anesth Pain Med. doi: 10.1097/AAP.0000000000000690