Safety and Efficacy of Genicular Nerve Radiofrequency Ablation for Management of Painful Total Knee Replacement: A Systematic Review.

Painful total knee replacement (TKR) without an obvious underlying identifiable pathology is not uncommon. Dissatisfaction after TKR can be up to 20%. Different treatment modalities, including non-operative and operative procedures, have been described in the literature. Radiofrequency ablation of genicular nerves (GNRFA) is emerging as a newer treatment modality for painful TKR without an obvious underlying identifiable pathology. Despite a modest number of publications demonstrating the usefulness of GNRFA in managing pain in knee osteoarthritis, the efficacy of GNRFA has not been completely established in the management of residual pain after TKR. This systematic review aimed to analyze all published studies (nine studies) on GNRFA as an option to manage residual pain after TKR. Based on this current systematic review, we noted that GNRFA is a modality to treat post residual pain and patients can anticipate improvement in pain up to three months with minimal complications. This article provides an overview of the currently available knowledge and techniques employed for this procedure, as well as the expected outcome and safety profile of GNRFA in painful TKR.

Extended Flexor Carpi Radialis Approach.

LEVEL OF EVIDENCE: Level V-Expert Opinion.