Overview
This study aims to compare the reduction in knee pain between ultrasound-guided cryoneurolysis and bipolar radiofrequency ablation (RFA), as measured by the Numerical Rating Scale (NRS) at predefined follow-up intervals.
Description
Knee osteoarthritis (KOA) is a major cause of chronic pain and disability worldwide. Pain in knee osteoarthritis is multifactorial and does not always correlate with the degree of radiographic degeneration. In addition to structural joint changes, pain results from synovial inflammation, subchondral bone remodeling, periosteal irritation, ligamentous stress, and sensitization of peripheral and central nociceptive pathways.
Among the available interventional approaches, radiofrequency ablation (RFA) and cryoneurolysis have gained increasing attention because they interrupt pain transmission without affecting joint stability. Radiofrequency ablation (RFA) and cryoneurolysis are two emerging techniques that modulate pain transmission pathways. Bipolar radiofrequency ablation uses thermal energy delivered between two closely positioned electrodes to create a larger and more continuous lesion than conventional monopolar RFA.
Eligibility
Inclusion Criteria:
- Age ≥ 40 years
- Symptomatic knee osteoarthritis (OA) in bladder cancer patient \[based on American College of Radiology (ACR) criteria\]
- Radiological OA (Kellgren-Lawrence grade III-IV)
- Chronic knee pain ≥ 3-6 months
- Numerical Rating Scale (NRS) ≥ 5 despite conservative treatment
- Positive diagnostic genicular nerve block (\>50% pain relief).
Exclusion Criteria:
- Prior genicular nerve ablation
- Coagulopathy
- Local infection
- Severe deformity
- Neuropathic pain syndromes
- Uncontrolled comorbidities
