Which one is more effective for the clinical treatment of chronic pain in knee osteoarthritis: radiofrequency neurotomy of the genicular nerves or intra‐articular injection?

摘要

Abstract Objectives To compare the efficacy of intra‐articular injection and radiofrequency ( RF ) neurotomy of genicular nerves in patients with chronic knee osteoarthritis ( OA ) pain. Methods Seventy‐three patients with knee OA were included in the study. Patients were randomly assigned to Group IA (intra‐articular 2.5 mL of bupivacaine, 2.5 mg of morphine and 1 mL of betamethasone, 6 mL of fluid injection) or Group RF ( RF neurotomy of the genicular nerves). The outcome measures included a pain scale (visual analog scale, VAS ) and Western Ontario and McMaster Universities ( WOMAC ) Index of Osteoarthritis. Results No statistically significant difference was found between the two groups in baseline VAS ‐pain. In Group RF , a significant reduction was observed in VAS ‐pain at the first month ( P 0.001) and the third month ( P 0.001) in comparison to Group IA . Also in Group RF , a significant reduction was observed in WOMAC total scores in the first month ( P 0.001) in comparison to Group IA . Conclusion This study is the first controlled study in the literature which compares RF genicular nerve to intra‐articular injections. This study demonstrated that genicular nerve RF neurotomy is a safe and efficient treatment modality and provides functional improvement along with an analgesia in patients with chronic knee OA .