Date of Award
2023
Degree Type
Selective Evidence-Based Medicine Review
Degree Name
Master of Science in Health Sciences - Physician Assistant
Department
Physician Assistant Studies
Abstract
OBJECTIVE: The objective of this systematic EBM review is to determine whether or not “Does genicular nerve radiofrequency ablation continue to reduce knee pain in adult patients with chronic knee osteoarthritis at six months after treatment?”
STUDY DESIGN: A review of three randomized controlled trials (RCTs) published between 2018 and 2021.
DATA SOURCES: All three RCTs were published in peer-reviewed journals and researched using PubMed. Studies were selected based on relevance to the clinical question.
OUTCOMES: All three RCTs measured knee pain as the primary outcome via the 10-point VAS pain scale or the 11-point NRS pain scale. Chen et al. and Davis et al. studies dichotomized data by further defining their outcomes as ≥50% pain reduction from baseline.
RESULTS: Elawamy et al. report difference of medians from baseline of -1 for both GNRFA and PRP on the VAS pain scale, with significant difference (p = 0.01) between the groups favoring GNRFA. Chen et al. data yield mean change from baseline of -4.2 and -2.0 for GNRFA and HA groups, respectively, on NRS pain scale. Chen et al. also report proportions with ≥50% pain reduction from baseline of 0.71 and 0.29 for GNRFA and HA, respectively, yielding NNT = 3. Davis et al. report mean change from baseline of -4.9±2.4 and -1.3±2.2 for GNRFA and IAS groups, respectively, on NRS pain scale (p < 0.0001). Davis et al. also report proportions with ≥50% pain reduction from baseline of 0.74 and 0.16, yielding NNT = 2.
CONCLUSIONS: The results are inconclusive. The results of Chen et al. and Davis et al. show that GNRFA greatly reduces knee pain and offers superior pain reduction compared to HA and IAS injections at six months after treatment, but conflict of interest cannot be ruled out. The Elawamy et al. study similarly favors GNRFA compared to PRP, but data interpretation is limited. Future research with larger sample size and consistent data reporting may lend clearer insight into GNRFA efficacy for OA-related knee pain.
Recommended Citation
Spata, Samantha K., "Does genicular nerve radiofrequency ablation continue to reduce knee pain in adult patients with chronic knee osteoarthritis at six months after treatment?" (2023). PCOM Physician Assistant Studies Student Scholarship. 655.
https://digitalcommons.pcom.edu/pa_systematic_reviews/655