Clinical and technical factors associated with knee radiofrequency ablation outcomes

Background There has been a surge in interest in radiofrequency ablation (RFA) of the genicular nerves over the past decade, with wide variability in selection, technique and outcomes. The aim of this study is to determine factors associated with treatment outcome. Methods We retrospectively evaluated the effect of 23 demographic, clinical and technical variables on outcomes in 265 patients who underwent genicular nerve RFA for knee pain at 2 civilian and 1 military hospital. A primary outcome was designated as a > 30% decrease in average knee pain score lasting at least 3 months without cointerventions. Results The overall rate of a positive response was 61.1% (95% CI 55.2% to 67.0%). In univariable analysis, larger electrode size (p=0.01), repeated lesions (p=0.02), having>80% pain relief during the prognostic block (p=0.02), not being on opioids (p=0.04), having no coexisting psychiatric condition (p=0.02), having a lower baseline pain score (p=0.01) and having >3 nerves targeted (p=0.02) were associated with a positive outcome. In multivariate logistic analysis, being obese (OR 3.68, 95% CI 1.66 to 8.19, p=0.001), not using opioids (OR 0.35, 95% CI 0.16 to 0.77, p=0.009), not being depressed (OR 0.29, 95% CI 0.10 to 0.82, p=0.02), use of cooled RFA (OR 3.88, 95% CI 1.63 to 9.23, p=0.002) and performing multiple lesions at each neural target (OR 15.88, 95% CI 4.24 to 59.50, p<0.001) were associated with positive outcome. Conclusions We identified multiple clinical and technical factors associated with treatment outcome, which should be considered when selecting patients for RFA treatment and in the design of clinical trials.



Work Title Clinical and technical factors associated with knee radiofrequency ablation outcomes
Subtitle A multicenter analysis
Open Access
  1. Yian Chen
  2. To Nhu H. Vu
  3. Vernon M. Chinchilli
  4. Mohamed Farrag
  5. Alexandra R. Roybal
  6. Albert Huh
  7. Zared O. Cohen
  8. Adam B. Becker
  9. Babak Arvanaghi
  10. Mrinal Agrawal
  11. Jacob Ogden
  12. Steven P. Cohen
License In Copyright (Rights Reserved)
Work Type Article
  1. Regional Anesthesia and Pain Medicine
Publication Date April 1, 2021
Publisher Identifier (DOI)
Deposited July 19, 2021




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  • Added Clinical_and_technical_factors_associated_with_knee_radiofrequency_ablation_outcomes__a_multicenter_analysis.pdf
  • Added Creator Yian Chen
  • Added Creator To Nhu H. Vu
  • Added Creator Vernon M. Chinchilli
  • Added Creator Mohamed Farrag
  • Added Creator Alexandra R. Roybal
  • Added Creator Albert Huh
  • Added Creator Zared O. Cohen
  • Added Creator Adam B. Becker
  • Added Creator Babak Arvanaghi
  • Added Creator Mrinal Agrawal
  • Added Creator Jacob Ogden
  • Added Creator Steven P. Cohen
  • Published
  • Updated
  • Updated
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