Long-term Effects of Ultrasound-guided Genicular Nerve Pulsed Radiofrequency on Pain and Knee Functions in Patients with Gonarthrosis.

Objective: Osteoarthritis of the knee is the most common musculoskeletal disease in older adults which causes chronic knee pain. Pulsed radiofrequency (PRF) on genicular nerves (GN) has become increasingly popular in the treatment of chronic knee pain due to its long duration of action and non-destructive therapy. This study aimed to reveal the effects of ultrasound-guided PRF therapy on GN in patients with knee osteoarthritis (KOA). Materials and Methods: This study included patients, who were diagnosed with gonarthrosis grade 3 to 4 according to the Kellgren-Lawrence classification which patients suffered from intractable knee pain, at least for six months despite conservative treatment. The ultrasound-guided PRF on GN (GPRF) was performed in those patients with a reduction of 50% or more visual analog scale (VAS) score after the diagnostic GN block (GNB). VAS and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores were evaluated before, and 1, 3, 6 and 12 months after the procedure. Results: Of the 293 patients included in the criteria, ultrasound-guided GPRF was administered to 232 patients who responded to GNB. While the mean VAS score of the patients before the GPRF was 6.77 ± 1.24, the mean VAS scores at the 1st, 3rd, 6th and 12th months of the GPRF were 2.76 ± 1.14, 2.94 ± 1.08, 3.53 ± 0.64, and 4.58 ± 0.75, respectively. The mean WOMAC score of the patients before GPRF was 65.75 ± 14.15, while the mean WOMAC score of the 1st, 3rd, 6th and 12th months after GPRF was 36.14 ± 13, 36.52 ± 11.06, 37.88 ± 10.86, and 41.67 ± 10.84, respectively. Conclusion: Ultrasound-guided GPRF therapy in chronic knee pain which does not respond to conservative treatments reduces pain for at least 12 months and is effective improving knee functions