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    Interventional procedure overview of radiofrequency denervation for osteoarthritic knee pain

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    Existing assessments of this procedure

    In 2022, the American Society of Pain and Neuroscience published the Consensus Guidelines on Interventional Therapies for Knee Pain (STEP Guidelines; Hunter, 2022). A literature search was performed to identify relevant studies, and consensus statements were formulated by a panel of specialists. There were 4 consensus statements relevant to RF treatment:

    • RF denervation of the SM, SL and IM genicular nerves is a safe and effective therapeutic option for treating knee pain secondary to osteoarthritis as well as pain refractory to total knee arthroplasty; Level 1, Grade A, Consensus Strong.

    • RF denervation of the SM, SL and IM genicular nerves can significantly reduce knee pain and improve function in patients with knee osteoarthritis and pain refractory to total knee arthroplasty; Level 1, Grade A, Consensus Strong.

    • Thermal or cooled RF denervation should be utilized when performing genicular nerve ablation; Level 1, Grade A, Consensus Strong.

    • In patients with persistent knee pain after genicular nerve ablation targeting the SM, SL and LM genicular nerves, one may consider targeting inferior lateral, medial retinacular nerve and/or infrapatellar branch of the saphenous nerve for supplemental treatment; Level III, Grade B, Consensus Moderate.

    In 2019, the American College of Rheumatology/Arthritis Foundation published the Guideline for the Management of Osteoarthritis of the Hand, Hip, and Knee (Kolasinski, 2020). A literature search was performed to identify relevant studies, and recommendations were voted upon by an interprofessional voting panel. The recommendation relevant to RF denervation was:

    • Radiofrequency ablation is conditionally recommended for patients with knee osteoarthritis.

      • A number of studies have demonstrated potential analgesic benefits with various ablation techniques but, because of the heterogeneity of techniques and controls used and lack of long-term safety data, this recommendation is conditional.