Genicular Nerve Radiofrequency Treatment for Chronic Knee Osteoarthritis Pain: A Systematic Review And Meta-Analysis of Randomized Controlled Trials Utilizing Image Guidance.

Authors

Yu-Ning Peng, Yu-Hsiang Peng, Hassan Ahad, Jay Karri, Scott Pritzlaff, Sma Alim, Steven P Cohen, Ryan S D'Souza, Ratan K Banik

Published in

Pain medicine (Malden, Mass.). Jul 06, 2026. Epub Jul 06, 2026.

Abstract

Genicular nerve radiofrequency (gRF) treatment is a widely used intervention for chronic pain from knee osteoarthritis (KOA). This systematic review and meta-analysis focuses on RCTs utilizing image guidance to address inconsistencies in previous reviews and provide higher-quality evidence.
This study included RCTs that compared gRF techniques (conventional, cooled, pulsed, bipolar) to non-gRF treatments, including sham procedures, intra-articular injections, ozone therapy, and oral medications. Primary and secondary outcomes were changes in pain and total WOMAC scores at 3, 6, and 12 months post-gRF treatments. Subgroup analyses explored differences by lesion size, use of prognostic blocks, industry sponsorship, and study location. Statistical heterogeneity was assessed via I  2 statistics.
Eleven RCTs with 868 knee osteoarthritis patients (435 gRF, 433 non-gRF) were included. At 3 months, gRF significantly reduced pain (SMD -1.65, 95% CI: -3.20 to -0.10, I  2 = 98%, P = 0.040), but not at 6 months or 12 months. Secondary analyses showed no significant differences in total WOMAC scores between the gRF and control groups at 3, 6, and 12 months. Subgroup analysis showed that industry-sponsored studies reported significant 3-month pain reduction, whereas non-sponsored studies did not. This effect was independent of study location.
GRF provides short-term pain relief (up to 3 months) but neither functional improvement nor sustained pain reduction compared to non-gRF treatments. Our findings do not support the routine use of gRF for long-term chronic pain due to KOA.

PMID:
42406393
Bibliographic data and abstract were imported from PubMed on 06 Jul 2026.

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