Complications and opioid-prescribing patterns following genicular nerve radiofrequency ablation versus intra-articular injection: a matched cohort study
Authors' conclusion
Our study demonstrated that GNRFA possesses a safety profile similar to that of intra-articular injections although significant adverse events such as venous thromboembolism and septic arthritis may occur rarely.
Study context
- Population
- Patients undergoing genicular nerve radiofrequency ablation (GNRFA) for knee osteoarthritis pain, 2015 to 2022, matched to patients receiving intra-articular corticosteroid (CSI) or hyaluronic acid injection (HAI) of the kneematched cohorts
- Exposure
- GNRFA vs intra-articular CSI or HAI of the knee
- Outcome
- Complication rates
- Follow-up
- 30 and 90 days
Methodological detailsretrospective, large national database
- Retrospective
- Large national database
Main finding
As reported in the abstract
Complications, CSI vs GNRFA · 30 days
P = 0.003
Observational data: associations, not effects.
Further findings
Opioid utilization · 6 months before and after treatment
- Pretreatment opioid utilization: no significant difference; mean daily morphine equivalents greater in GNRFA
- No prior opioid use: utilization significantly increased in the first 30 days after ablation vs controls
- Some or chronic prior opioid use: requirements generally decreased in all groups at 6 months; no clearly superior treatment
Safety
Complications, CSI vs GNRFA · 90 days
- Septic arthritis, DVT, PE and nerve injury: not significantly different (as printed: 0.1% vs 0.3%; 3.1% vs 3.1%; 1.5% vs 1.8%; 0% vs <0.1%)
Complications, HAI vs GNRFA · 30 days
- Infection, septic arthritis, DVT, PE, bleeding, seroma, nerve injury, swelling and thermal injury: no significant differences (swelling as printed: 14.0% vs 12.0%)
Complications, HAI vs GNRFA · 90 days
- Infection, septic arthritis, DVT, PE and nerve injury: not significantly different (as printed: 0.7% vs 1.4%; 0.3% vs 0.5%; 3.6% vs 3.1%; 2.3% vs 2.1%; 0% vs 0.1%)
Original publication
Complications and opioid-prescribing patterns following genicular nerve radiofrequency ablation versus intra-articular injection: a matched cohort study. Reg Anesth Pain Med. Published 1 February 2024. doi:10.
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