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Long-Term Outcomes of the Pull-Back Technique for Genicular Nerve Ablation
John B Smirniotopoulos1, Neil K Jain2, Aazrin Mir3
1Division of Interventional Radiology, Department of Radiology, Washington, DC; Division of Interventional Radiology, Department of Radiology; MedStar Washington Hospital Center; Washington, DC.
Purpose:
To test the hypothesis that the pull-back genicular nerve ablation (pbGNA) technique provides superior 12-month pain relief and functional improvement compared with traditional genicular nerve ablation (tGNA) for knee osteoarthritis, as measured by visual analog scale (VAS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores.
Materials And Methods:
A single-center, nonrandomized retrospective analysis of a prospectively collected cohort of patients undergoing genicular nerve block and ablation between September 2022 and February 2024 was performed. Technique selection was based on operator preference. Baseline and 12-month VAS and WOMAC scores were compared between groups. Demographics including age, gender, and body mass index (BMI) were analyzed. Univariate and multivariate linear regressions assessed associations between technique and score changes, adjusting for clinical and demographic covariates.
Results:
Sixty-eight patients were included (male, 19%; median age, 67 years; median BMI, 35 kg/m2). Twenty-six underwent pbGNA, and 41 underwent tGNA, with no significant baseline differences. In the pbGNA group, VAS score improved by 2.92 (P < .001), and WOMAC score improved by 12.65 (P = .001) at 12 months. On multivariate analysis, pbGNA was not associated with greater VAS improvement (β = 0.71, P = .435) but was associated with greater WOMAC improvement (β = 15.39, P = .040).
Conclusions:
pbGNA appears safe and may improve functional outcomes compared with tGNA without compromising pain relief. However, findings should be interpreted cautiously given the modest effect size, wide CI, and small single-center sample in this retrospective nonrandomized study.
