Comparison of the efficacy of 3 point versus 5 point genicular nerve radiofrequency ablation in patients with chronic knee osteoarthritis: A randomized control study

Knee osteoarthritis is a prevalent cause of chronic pain and disability, and many patients are unsuitable or unwilling for total knee arthroplasty. Radiofrequency ablation of genicular nerves offers a minimally invasive alternative for pain relief. However, the optimal number of target nerves remains unclear. The conventional 3-point RFA may not capture all pain-transmitting genicular branches, whereas the newer 5-point approach could potentially improve efficacy by addressing additional nerve targets. This study aims to provide high-quality comparative evidence on the functional and analgesic outcomes of both techniques, helping define a more effective and standardized RFA protocol for knee osteoarthritis management.

This randomized controlled study will be conducted at the Department of Anaesthesiology, Lady Hardinge Medical College, New Delhi, from August 2025 to November 2026. Sixty patients aged 40–75 years with chronic knee osteoarthritis (Kellgren-Lawrence grade II–IV) unresponsive to conservative therapy and showing more than 50 percent pain relief after diagnostic genicular nerve block will be enrolled. Participants will be randomly allocated (block randomization) into two groups:

• Group T: 3-point genicular nerve radiofrequency ablation (RFA)
• Group F: 5-point genicular nerve RFA

All procedures will be performed under ultrasound guidance using standard monitoring. Each target nerve will be confirmed by sensory and motor stimulation before lesioning at 80°C for 90 seconds. Patients will be followed at 1 week, 1 month, and 3 months post-procedure to assess pain (Numerical Rating Scale) and function (Oxford Knee Score). Data will be analyzed using SPSS v23, with statistical significance set at p less than 0.05.