Abstract
Background: In knee osteoarthritis (KOA), cooled radiofrequency ablation (C-RFA) and conventional radiofrequency ablation (Conv-RFA) are seldom compared directly, and long-term outcome is unclear. Aim: The aim is to compare the efficacy and safety of C-RFA and Conv-RFA in patients with Kellgren and Lawrence grade ≥3. Settings and Design: This prospective, randomized, double-blind study was performed over 30 months (October 2020 to March 2023) with 12 months follow-up in the Department of Pain Medicine. Materials and Methods: The study included 30 patients each in C-RFA and Conv-RFA groups. The outcomes were assessed at baseline, 3, 6, and 12 months and included pain relief (Visual Analogue Scale [VAS] score), rescue analgesic use, functional improvement (Western Ontario and McMaster Universities Osteoarthritis Index [WOMAC] scores), and adverse events. Results: At 12 months, both C-RFA and Conv-RFA groups had a significant reduction in VAS score and analgesic use as well as an improvement in WOMAC score (P < 0.0001). In the C-RFA group, VAS score and analgesic use decreased, while WOMAC score improved significantly at 3, 6, and 12 months compared to baseline (P < 0.0001). At corresponding intervals, similar changes were observed in the Conv-RFA group at all the intervals, except no significant reduction in VAS score at 12 months (P = 0.900). The groups had comparable VAS and WOMAC scores at baseline, 3, and 6 months; however, at 12 months, the VAS score decreased significantly and the WOMAC score improved significantly in C-RFA groups (P < 0.0001). Conclusions: C-RFA provided significantly greater and prolonged pain relief and functional improvement in patients with KL grade III–IV KOA, and thus is superior to Conv-RFA.
Published Version
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