Rates of knee arthroplasty after genicular nerve ablation: A retrospective study utilizing a large national database

Area of Science:

• Orthopedics
• Pain Management
• Minimally Invasive Procedures

Background:

• Genicular nerve ablation (GNA), encompassing radiofrequency ablation, cryoneurolysis, and chemical neurolysis, is a minimally invasive treatment for knee osteoarthritis (KOA).
• GNA shows promise for improving pain and function in KOA patients.
• GNA may offer an alternative to conservative treatments with variable efficacy and knee arthroplasty (KA) with its associated risks, potentially delaying or deferring surgery.

Purpose of the Study:

• To evaluate the rate of patients undergoing knee arthroplasty (KA) after receiving genicular nerve ablation (GNA).
• To determine the incidence of total knee arthroplasty (TKA) or unicompartmental knee arthroplasty (UKA) following GNA.

Main Methods:

• A retrospective analysis of the TriNetX national database was conducted.
• Patients aged 18+ who underwent GNA between 2004 and 2025 were included, excluding those with severe comorbidities or prior KA.
• Descriptive analyses calculated the incidence and cumulative incidence of post-GNA TKA or UKA.

Main Results:

• Out of 6035 patients who underwent GNA, 795 (13.2%) received TKA or UKA.
• The cumulative incidence of KA after GNA was 1.3% at 3 months, 3.5% at 6 months, 7.2% at 1 year, 10.3% at 2 years, and 12.4% at 5 years.
• These findings suggest GNA may provide significant symptom relief, potentially delaying the need for KA.

Conclusions:

• This study represents the largest cohort to date examining KA rates post-GNA.
• Approximately 13.2% of patients in the cohort underwent KA after GNA, indicating GNA's potential to delay or defer surgery.
• Further research is warranted to explore the cost-effectiveness and surgical-sparing efficacy of GNA for symptomatic KOA.