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Objectives <p>To evaluate the efficacy of continuous ultrasound-guided genicular nerve radiofrequency (GNRF) for managing persistent post-arthroplasty knee pain of unknown etiology.</p> Materials and methods <p>In this single-center retrospective study, patients presenting with chronic knee pain following total knee arthroplasty, with no identifiable underlying cause and unresponsive to conventional treatments, underwent ultrasound-guided diagnostic nerve blocks followed by continuous GNRF targeting the supero-medial, supero-lateral, and infero-medial genicular nerves. Pain scores using a numeric rating scale (NRS) were assessed and compared at baseline, 1 month, and 6 months. The correlation between anesthetic nerve block test results and treatment efficacy was also analyzed.</p> Results <p>Twenty-three patients (mean age 69.9 ± 12.1 [SD], 9 men) were included between December 2021 and April 2024. At 1 month, the mean NRS score decreased from 8.0 ± 1.4 to 6.0 ± 3.4 [SD] (<i>p</i> = 0.01). Clinically significant pain reduction (≥ 2-point decrease) was observed in 47.8% of patients; 34.8% achieved a ≥ 50% reduction. At 6 months, the mean NRS score was 6.6 ± 3.0 [SD], with no statistically significant difference compared to baseline and 1-month NRS scores. No significant correlation was found between nerve block test outcomes and GNRF efficacy. No major complications were reported.</p> Conclusion <p>Continuous ultrasound-guided GNRF appears to be a safe and effective minimally invasive option for chronic post-arthroplasty knee pain with no known underlying etiology.</p> Key Points <p><Emphasis Type="BoldItalic">Question</Emphasis> <i>Persistent post-arthroplasty knee pain with no identified underlying etiology is frequent and often difficult to manage with conventional therapies</i>.</p> <p><Emphasis Type="BoldItalic">Findings</Emphasis> <i>Ultrasound-guided continuous</i> <i>GNRF provides clinically significant pain relief at 1 month and up to 6 months</i>.</p> <p><Emphasis Type="BoldItalic">Clinical relevance</Emphasis> <i>Prognostic nerve blocks did not correlate with radiofrequency outcomes</i>.</p> Graphical Abstract <p></p>

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Assessment of ultrasound-guided continuous genicular nerve radiofrequency for the management of persistent post-arthroplasty knee pain

  • 期刊论文

  • 发表日期：

    2025年12月23日

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  • Rokia El Khalfi,
  • Émilie Larribeau,
  • Pablo Froidefond,
  • Agathe Saint-Denis,
  • Hélène Chiavassa-Gandois,
  • Céline Goumarre,
  • Antoine Filliole,
  • Franck Lapègue,
  • François Lafourcade,
  • Viet-Tam Van,
  • Nicolas Sans,
  • Etienne Cavaignac,
  • Marie Faruch-Bilfeld

摘要

Objectives

To evaluate the efficacy of continuous ultrasound-guided genicular nerve radiofrequency (GNRF) for managing persistent post-arthroplasty knee pain of unknown etiology.

Materials and methods

In this single-center retrospective study, patients presenting with chronic knee pain following total knee arthroplasty, with no identifiable underlying cause and unresponsive to conventional treatments, underwent ultrasound-guided diagnostic nerve blocks followed by continuous GNRF targeting the supero-medial, supero-lateral, and infero-medial genicular nerves. Pain scores using a numeric rating scale (NRS) were assessed and compared at baseline, 1 month, and 6 months. The correlation between anesthetic nerve block test results and treatment efficacy was also analyzed.

Results

Twenty-three patients (mean age 69.9 ± 12.1 [SD], 9 men) were included between December 2021 and April 2024. At 1 month, the mean NRS score decreased from 8.0 ± 1.4 to 6.0 ± 3.4 [SD] (p = 0.01). Clinically significant pain reduction (≥ 2-point decrease) was observed in 47.8% of patients; 34.8% achieved a ≥ 50% reduction. At 6 months, the mean NRS score was 6.6 ± 3.0 [SD], with no statistically significant difference compared to baseline and 1-month NRS scores. No significant correlation was found between nerve block test outcomes and GNRF efficacy. No major complications were reported.

Conclusion

Continuous ultrasound-guided GNRF appears to be a safe and effective minimally invasive option for chronic post-arthroplasty knee pain with no known underlying etiology.

Key Points

Question Persistent post-arthroplasty knee pain with no identified underlying etiology is frequent and often difficult to manage with conventional therapies.

Findings Ultrasound-guided continuous GNRF provides clinically significant pain relief at 1 month and up to 6 months.

Clinical relevance Prognostic nerve blocks did not correlate with radiofrequency outcomes.

Graphical Abstract