Effectiveness of fluoroscopy guided cryoablation of genicular nerves in comparison with steroid and local anaesthetic block in improving pain and function in patients with grade 3 and 4 osteoarthritis of knee: A randomised controlled trial

Knee osteoarthritis is a progressive chronic degenerative musculoskeletal disease of the knee joint which is the most commonest rheumatological condition causing pain, functional impairment, chronic disability, and diminished quality of life. Diagnosis will be made by the 2016 ACR criteria for early diagnosis of knee osteoarthritis. Treatment should aim to relieve pain, improve function, limit disabilities, and improve quality of life. Surgery is the definitive management of the later stages of OA knee. So later stages of the disease and associated chronic pain should be treated wisely with minimal side effects.  Cryoablation of genicular nerves has recently become popular in the management of chronic osteoarthritic knee pain due to its potential of allowing for complete regeneration and functional recovery of nerves with fewer adverse effects. The greatest limitation of cryoablation is the lack of standardization. This study a single-blinded randomized controlled trial shall be conducted in the Department of Physical Medicine and Rehabilitation to determine the effectiveness of fluoroscopy-guided cryoablation in comparison with local anaesthetic and steroid block of genicular nerves in the treatment of patients with grade 3 and 4 osteoarthritis of the knee. A sample size of 82 patients of grade 3 and 4 osteoarthritis of knee attending PMR OPD, RIMS with knee pain will be chosen and randomized. Outcomes will be measured using the VAS (Visual Analogue Scale) and WOMAC at baseline, and post-intervention at 1st, 4th, 12th, and 24th weeks. For calculation, the Chi-square test, independent t-test, and repeated measure ANOVA will be used and a p-value <0.05 will be taken as significant.