Radiofrequency denervation for osteoarthritic knee pain

2.1 Osteoarthritis is characterised by localised loss of cartilage, remodelling of adjacent bone and associated inflammation. Knees are one of the most affected joints, with pain being a significant symptom.

2.2 Various treatments are available for pain caused by knee osteoarthritis, including non-pharmacological (such as physiotherapy), pharmacological (such as analgesics and intra-articular corticosteroids) and surgical approaches (such as knee arthroplasty). When non-pharmacological and pharmacological interventions do not work or symptoms are severe, surgery may be needed.

2.3 This procedure is often done in 2 stages. Both are done under fluoroscopic or ultrasound guidance. First, to assess suitability for radiofrequency denervation, people are given a diagnostic nerve block by injecting a local anaesthetic to the target nerves. If the diagnostic nerve block relieves the pain, the person is a candidate for radiofrequency denervation.

2.4 A probe is introduced to the treatment site. Several targets have been described, including the genicular nerves, the saphenous nerve, and the articular cavity. Radiofrequency energy is used to denervate the target nerves. The radiofrequency energy can be delivered as conventional radiofrequency, cooled radiofrequency or pulsed radiofrequency. The aim is to reduce pain and delay the need for knee arthroplasty.