# Cooled Radiofrequency Ablation Versus Cryoneurolysis of the Genicular Nerves for the Symptomatic Pain Management in Knee Osteoarthritis: A Prospective, Randomized, Single-Blinded Clinical Trial

## TL;DR

This study compares cooled radiofrequency ablation and cryoneurolysis for knee osteoarthritis pain, finding that cooled radiofrequency ablation provides longer-lasting relief.

## Contribution

The study provides a direct comparison of two minimally invasive treatments for knee osteoarthritis using a randomized clinical trial.

## Key findings

- Both treatments reduced pain and improved outcomes, but cooled radiofrequency ablation showed better results at six months.
- Cooled radiofrequency ablation significantly improved pain scores and functional outcomes compared to cryoneurolysis.
- No serious adverse events were reported with either treatment.

## Abstract

Purpose: Knee osteoarthritis (KOA) is a common disease that significantly affects the quality of life of patients. Among several nonsurgical methods of symptomatic treatment, cooled radiofrequency ablation (CRFA) and cryoneurolysis (CRYO) have gained traction recently. This study compared the two methods in their capacity to reduce pain and improve clinical outcomes in patients with KOA.

Methods: This was a prospective, randomized, single-blinded clinical trial that included 25 patients with KOA in each group. The classic targets of the superior lateral and medial genicular and inferior medial genicular nerves were used, as well as the medial (retinacular) genicular branch from the vastus intermedius. Patients were evaluated using the Numerical Pain Scale (NRPS), the Knee Injury and Osteoarthritis Outcome Score (KOOS), and the Oxford Knee Score (OKS) at baseline and at one, three, and six months post-intervention.

Results: Both methods were able to reduce pain and display improved clinical outcomes in all three post-intervention evaluations. However, at the six-month mark, CRFA showed a clear advantage: NRPS decreased from a baseline mean of 7 to 3.1 (compared to 6.2 for cryoneurolysis); KOOS improved from a baseline mean of 45.4 to 64 (compared to 56 for cryoneurolysis); OKS improved from a baseline mean of 20 to 33 (compared to 26 for cryoneurolysis). No serious procedure-related adverse events were reported.

Conclusions: Both CRFA and cryoneurolysis of the genicular nerves are effective treatment options for KOA symptoms. However, CRFA displays a more durable therapeutic effect after the one-month period, with a clear advantage at the six-month evaluation.