Patient-Reported Outcomes Following Two-Tined Three-Site Conventional Radiofrequency Ablation of Genicular Nerves for Chronic Knee Pain

Cureus. 2026 Sep 18;18(9):e116510. doi: 10.7759/cureus.116510. eCollection 2026 Sep.

ABSTRACT

BACKGROUND: Genicular nerve radiofrequency ablation (GNRFA) has emerged as an effective therapy for chronic knee pain. Although some studies have evaluated its effectiveness, there is limited real-world data on the long-term patient-reported outcome (PRO) data for GNRFAs.

OBJECTIVE: This study aimed to evaluate PROs following conventional GNRFAs performed using two-tined electrodes and the classical three-site technique targeting the superior medial, superior lateral, and inferior medial genicular nerves.

METHODS: We performed a retrospective chart review to gather data from consecutive GNRFAs at an academic medical center from 2016 to 2023. Inclusion criteria were all adult patients who received a conventional GNRFA performed using the classical three-site technique using two-tined electrodes. All included subjects were confirmed to have a positive diagnostic response (≥50% Numeric Rating Scale (NRS) reduction) to a previous genicular nerve block. Primary outcomes were NRS pain scores, Patient Reported Outcomes Measurement Information System (PROMIS) Global Health, and Patient Health Questionnaire-9 (PHQ-9).

RESULTS: A total of 31 patients underwent 38 GNRFAs. Relative to the pre-procedure baseline, the average NRS reduction post-procedurally was -3.17 during 0-3 months (p<0.0001), -1.31 during 3-6 months (p<0.05), and -1.92 during 6-12 months (p<0.05). Half of all patients maintained pain relief (NRS reduction greater than or equal to a minimal clinically important difference (MCID) of -2.0) for 11.17 months (95% CI: 7.29, 13.40). Although there was a positive trend for improvement in the quality-of-life measures, no statistically significant post-procedure improvement or worsening was observed during all time periods for PROMIS Physical Health, PROMIS Mental Health, and PHQ-9. Lastly, a history of depression was associated with treatment failure.

CONCLUSION: In this real-world cohort, conventional GNRFA using the classical three-site technique demonstrated robust short-term pain reduction, and at least half of the cohort maintained clinically meaningful pain improvements for 11 months. For chronic knee pain, GNRFA is a reasonable therapeutic option in appropriately selected patients.

PMID:42898139 | PMC:PMC13677339 | DOI:10.7759/cureus.116510