title: Which one is more effective for the clinical treatment of chronic pain in knee osteoarthritis: radiofrequency neurotomy of the genicular nerves or intra-articular injection?
abstract: OBJECTIVE
  To compare the efficacy of intra-articular injection and radiofrequency (RF) neurotomy of genicular nerves in patients with chronic knee osteoarthritis (OA) pain.
  
  
  METHODS
  Seventy-three patients with knee OA were included in the study. Patients were randomly assigned to Group IA (intra-articular 2.5 mL of bupivacaine, 2.5 mg of morphine and 1 mL of betamethasone, 6 mL of fluid injection) or Group RF (RF neurotomy of the genicular nerves). The outcome measures included a pain scale (visual analog scale, VAS) and Western Ontario and McMaster Universities (WOMAC) Index of Osteoarthritis.
  
  
  RESULTS
  No statistically significant difference was found between the two groups in baseline VAS-pain. In Group RF, a significant reduction was observed in VAS-pain at the first month (P < 0.001) and the third month (P < 0.001) in comparison to Group IA. Also in Group RF, a significant reduction was observed in WOMAC total scores in the first month (P < 0.001) in comparison to Group IA.
  
  
  CONCLUSIONS
  This study is the first controlled study in the literature which compares RF genicular nerve to intra-articular injections. This study demonstrated that genicular nerve RF neurotomy is a safe and efficient treatment modality and provides functional improvement along with an analgesia in patients with chronic knee OA.
authors: Department of Anesthesiology, Medical Faculty, Adnan Menderes University, Aydin, Turkey.
authors: Sinem
authors: S
authors: Sarı
authors: Department of Algology, Medical Faculty, Adnan Menderes University, Aydin, Turkey.
authors: Osman N
authors: ON
authors: Aydın
authors: Department of Physical Medicine and Rehabilitation, Medical Faculty, Adnan Menderes University, Aydin, Turkey.
authors: Yasemin
authors: Y
authors: Turan
authors: Department of Algology, Medical Faculty, Adnan Menderes University, Aydin, Turkey.
authors: Pınar
authors: P
authors: Özlülerden
authors: Department of Anesthesiology, Medical Faculty, Adnan Menderes University, Aydin, Turkey.
authors: Ufuk
authors: U
authors: Efe
authors: Department of Biostatistics, Medical Faculty, Adnan Menderes University, Aydin, Turkey.
authors: İmran
authors: İ
authors: Kurt Ömürlü
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000700:Analgesics / Q000008:administration & dosage* / Q000009:adverse effects; D000701:Analgesics, Opioid / Q000008:administration & dosage; D000779:Anesthetics, Local / Q000008:administration & dosage; D018771:Arthralgia / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D001623:Betamethasone / Q000008:administration & dosage; D002045:Bupivacaine / Q000008:administration & dosage; D059350:Chronic Pain / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D003714:Denervation / Q000009:adverse effects / Q000379:methods*; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage; D006801:Humans; D007270:Injections, Intra-Articular; D007719:Knee Joint / Q000294:innervation*; D008297:Male; D008875:Middle Aged; D009020:Morphine / Q000008:administration & dosage; D020370:Osteoarthritis, Knee / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D010147:Pain Measurement; D011446:Prospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D014421:Turkey
chemical_list: D000700:Analgesics; D000701:Analgesics, Opioid; D000779:Anesthetics, Local; D005938:Glucocorticoids; D009020:Morphine; D001623:Betamethasone; D002045:Bupivacaine
keywords: genicular nerve; intra-articular injections; knee osteoarthritis; radiofrequency