Cooled radiofrequency ablation better than steroids for knee osteoarthritis
Compared with injection of intra-articular steroids (IAS), cooled radiofrequency ablation (CRFA) is more effective at long-term pain management and physical function improvement for painful knee osteoarthritis (OA), a new study suggests.
The prospective randomized trial included 151 chronic knee pain patients who were unresponsive to conventional, conservative treatment approaches, and who were randomized in a 1:1 ratio to receive either IAS (n=75; mean age at consent 66±13 years) or CRFA (n=76; mean age at consent 63±12 years). Follow-up visits were at 1, 3 and 6 months postintervention.
The research team compared the primary efficacy endpoint, defined as the proportion of patients with at least 50-percent reduction in knee pain from baseline, between the two treatment groups. Analgesic use, knee function and adverse events (AEs) were included as secondary endpoints.
While baseline pain scores for the CRFA (7.3±1.2) and IAS (7.2±1) groups were not significantly different from each other, scores for the CRFA group were significantly lower at 1 (3±2.3 v 3.9±2.2; p=0.025), 3 (2.8±2.2 v 5.2±2; p<0.0001) and 6 (2.5±2.3 vs 5.9±2.2; p<0.0001) months. Reduction in pain scores were significant for both groups (p<0.0001 at each time point) relative to baseline.
Moreover, a significantly larger proportion of the CRFA group met the criteria for a successful outcome at 6 months compared with the IAS group (74 v 16 percent; p<0.0001). In contrast, there were more nonresponders in the IAS than CRFA group (83.8 vs 25.9 percent).
“[T]he findings of this study indicate that CRFA for genicular nerve ablation is superior to a single corticosteroid injection in [OA patients] for managing knee pain,” said the researchers.