Thermal Nerve Radiofrequency Ablation for the Nonsurgical Tr
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Nerve radiofrequency ablation (RFA) is a nonsurgical procedure for the management of knee OA symptoms, and no previous systematic review has been performed comparing geniculate nerve RFA to other nonsurgical treatments.

A systematic literature review was conducted evaluating the relative effectiveness of geniculate nerve thermal (heated or cooled) RFA compared with other nonsurgical treatments for knee OA. Two independent abstractors reviewed and analyzed the literature including comparators such as intra-articular (IA) corticosteroids, IA hyaluronic acid, NSAIDs, acetaminophen (paracetamol), and control/sham procedures.

--5 high-quality and 2 moderate-quality randomized controlled trials (RCTs) met the inclusion criteria for this review.

--The results showed consistent agreement across all RCTs in favor of geniculate nerve thermal RFA use for nonsurgical treatment of knee OA.

--One high-quality RCT and one moderate-quality RCT found geniculate nerve RFA to provide statistically significant outcome improvement compared with control or sham procedures regarding pain, function, quality of life, and composite scores.

--When compared with IA corticosteroids and hyaluronic acid, geniculate nerve RFA also provided notable improvement in pain, function, and composite scores (visual analog scale, Western Ontario, and McMaster Universities Arthritis Index, and Oxford Knee Score).

--RFA was markedly favored for all pain and composite outcomes. The included RCTs did not report any serious AEs related to geniculate nerve RFA.

In comparison to NSAIDs and IA corticosteroid injections, these findings show that geniculate nerve thermal RFA is a superior nonsurgical treatment for knee OA. In contrast to documented cardiovascular, gastrointestinal, and renal AEs for NSAIDs and accelerated cartilage loss and periprosthetic infection risk for IA corticosteroid injections, none of the RCTs recorded any severe AEs with geniculate nerve thermal RFA.