Ultrasound-guided radiofrequency neurotomy of genicular nerves alleviates intractable pain and disability in the majority of patients with advanced osteoarthritis of the knee. Such a treatment is safe and minimally invasive and can be performed in an outpatient setting. The beneficial effect of treatment started to decline after 6 months, but even 1 year after the intervention, 32% of patients reported 50% improvement or greater in pretreatment VAS scores.

Recibido: 15-07-13. Aceptado: 25-10-13.Ramírez Ogalla I, Moreno Martín A, Santana Pineda MM, Rodríguez Huertas F. Eficacia de la radiofrecuencia convencional de geniculados para el tratamiento del dolor en gonartrosis moderada-severa. Rev Soc Esp Dolor 2014; ABSTRACT Introduction: Knee osteoarthritis is a common joint disease in the elderly characterized by pain, stiffness and functional limitation, and daily life disability.Objective: The purpose of this study was to assess the outcome in terms of pain, functional recovery, and side effects during six month of radiofrequency treatment applied to the articular nerve branches (genicular nerves) in patients with chronic knee pain. As secondary outcome we investigated pharmacological therapy reduction and patient's satisfaction after treatment.Material and methods: This prospective, uncontrolled study involved 16 elderly patients with severe knee osteoarthritis pain after genicular nerve radiofrequency treatment. Visual analogic scale (VAS) was measured at baseline (before treatment), at one, three and six months post-procedure. For measurement of functional limitation we used the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) before treatment, and three and six months after procedure. Treatment response was defined as at least 50 % of VAS reduction. We also registered patient's satisfaction after treatment.Results: We included 16 patients with severe knee osteoarthritis pain lasting more than three months, VAS score higher than 5, severe osteoarthritis in Kellgren-Lawrence classification (3-4) and pain resistant to conventional care. We found significant differences in the mean VAS value before radiofre-quency 7 (6-8) and after one 3,5 (1-6), three 3,3 (1-7) and six months 3,37 (1-8) after treatment. 75 % of patients had 50 % of VAS score reduction after one month, 68,75 % of patients after three months and 65 % of patients after six months (p = 0,009). Moreover, we also found significant differences in WOMAC score mean values before treatment 65,8 (54-79) and after three 54,7 (41-67) and six 50,3 (37-69) months after radiofrequency. No patient reported a post-procedure adverse event during de follow-up period.Conclusions: RF application to genicular nerves showed significant benefit in terms of pain reduction and functional improvement in a 6 month follow-up in patients with chronic knee osteoarthritis and thus may be an effective treatment in such cases. Further trials with larger sample size and longer follow-up are needed.

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