Ultrasound-guided thermal radiofrequency ablation of the genicular nerves after total knee replacement.

The rate of refractory chronic pain after total knee replacement (TKR) is 20-25%, with no identifiable etiology in 6% of cases. Without an etiologic diagnosis, the surgeon is unlikely to consider revision, but pain poses a therapeutic challenge for achieving satisfaction and an acceptable quality of life. Genicular nerve radiofrequency ablation (GNRFA) was recently developed as a non-drug analgesic option. It is minimally invasive and safe, with few adverse effects, opening a new perspective for management of refractory chronic pain after TKR. LEVEL OF EVIDENCE: IV.