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961 - Holistic Approach to Evaluating Efficacy of Genicular Nerve Radiofrequency Ablation in Pre- and Post-Total Knee Arthroplasty Patients

Friday, February 28, 2025

5:00 PM - 6:30 PM MST

Presenting Author(s)

PB

Patrick Bruch, MD

Presenter, First Author, and Medical Student
Southern Illinois University School of Medicine
Springfield, Illinois, United States

Co-Author(s)

GA

Gordon Allan, MD

Principal Investigator
Orthopedic Center of Illinois and SIU School of Medicine
Springfield, Illinois, United States
LG

Louis Graham, MD

Director of Inpatient Rehabilitation
Memorial Medical Center
Springfield, Illinois, United States

Corresponding Author(s)

ST

Sowmyanarayanan Thuppal PhD, MD

Corresponding Author
SIU School of Medicine
Springfield, Illinois, United States

Co-Author(s)

KD

Kristin Delfino, PhD

Biostatistician, Co-author
SIU School of Medicine
Springfield, Illinois, United States

Objectives: Genicular nerve radiofrequency ablation (RFA) is a conservative treatment recommended for chronic pain caused by osteoarthritis and post-total knee arthroplasty (TKA). The procedure works by burning the nerves surrounding the knee, which prevents pain sensation to the brain. Current recommendations indicate that RFA can be useful from six months to one year. However, research is limited in the duration of efficacy beyond six months. The objective of this study is to evaluate the duration of adequate pain control with RFA.

Design: A retrospective chart review of patients who underwent RFA was reviewed from January 2020 to August 2024. The main outcome was duration of effective pain control, defined as greater than 50 percent reduction in pain scores on a scale of 0 to 10. Holistic considerations included BMI, smoking status, insurance, and osteoarthritis versus other cause for pain.

Results: Six patients qualified from this sample by having an RFA procedure done. Of the available five baseline pain scores, four had a score of 8, and one had a score of 7. Five of the six patients went on to have at least one additional RFA procedure. The duration of effective pain control from first RFA to second ranged from 192 to 973 days, with a median of 593. Two patients were treated for osteoarthritis, one for prior bone tumor, one for post-TKA pain and synovitis, and one for chronic knee pain after knee reconstruction surgery for significant trauma.

Conclusions: RFA is an advantageous, conservative management option that shows potential for greater utilization in chronic knee pain, beyond osteoarthritis. This study showed efficacy past 6 months and 1 year. Additional research on total duration of pain control and types of pain being controlled would offer greater clarification on the clinical relevance of this conservative treatment.