Does central sensitization affect responses to genicular radiofrequency and intra-articular injection in elderly knee...

This study aimed to evaluate the effect of central sensitization level on treatment response in individuals older than 65 years who underwent genicular nerve radiofrequency and intra-articular injection treatments for knee osteoarthritis (OA).

In this retrospective cohort study, 37 patients were divided into two groups according to the Central Sensitization Inventory (CSI) score (CSI<40 and CSI≥40). All patients underwent genicular nerve radiofrequency ablation and intra-articular injection. Pain (NRS), functionality (WOMAC), walking capacity (6MWT), sleep quality (PSQI), and satisfaction levels were evaluated at baseline and at 1 and 3 months following the procedure. Variance and regression analyses were used for statistical evaluation.

Significant clinical improvements were observed in all patient groups for the evaluated parameters (p<0.001). However, variance analysis for pain (F=22.566, p<0.001), function (F=15.283, p<0.001), sleep quality (t=-3.87, p<0.001), and walking capacity (F=13.301, p=0.001) showed lower scores in the CSI≥40 group compared with the CSI<40 group. Regression analysis confirmed lower responses in CSI≥40 patients: pain (β=-2.1; 95% CI: -3.1 to -1.1; p<0.001), function (β=-4.6; 95% CI: -7.2 to -2.0; p=0.001), walking (β=-24.6; 95% CI: -40.7 to -2.8; p=0.026), and sleep (β=-1.9; 95% CI: -2.9 to -0.9; p=0.001).

The presence of central sensitization significantly limits the clinical response to genicular radiofrequency ablation and intra-articular injection treatments in older patients with OA. Routine use of screening tools such as CSI in treatment planning may guide more effective and personalized approaches.