Genicular Nerve Radiofrequency Ablation for Persistent Postsurgical Pain After Total Knee Arthroplasty: A Systematic Review of Clinical Effectiveness and Safety.

Abstract

<h4>Introduction</h4>Total knee arthroplasty is an effective and established surgical treatment of knee osteoarthritis. However, patients report significant perioperative pain and persistent postsurgical pain, which in turn affect the recovery of the patients. Current treatment options include multimodal analgesia. Lately, RFA has been suggested as a procedure for post-TKA pain management. This systematic review is aimed at critically evaluating the current evidence on the effectiveness and safety of RFA of the genicular nerve as a persistent postoperative pain management in patients after TKA.<h4>Methods</h4>This systematic review focused on RCTs and cohort studies. The search of the literature was done on several databases.<h4>Results</h4>Ten studies, including one RCT and nine retrospective cohort studies with a total of 211 patients, were included. Studies included different RFA techniques and imaging modalities. All studies reported improvement in outcome measures after the procedure according to different scales. The bias assessment revealed moderate-to-high risk. The statistical analysis was not done due to heterogeneity of the results.<h4>Conclusion</h4>GNRFA is a promising modality, which reports improvement in outcome measures and absence of adverse effects. It is promising for selected patients but requires RCTs for routine use.