One hundred and fifty-one patients with knee osteoarthritis (OA) who received either cooled radiofrequency ablation (CRFA; n=76) therapy or intra-articular corticosteroid (IAS; n=4/75) injections were included in this 12 month follow-up study. After 6 months, patients in the IAS group were offered the opportunity to cross over to CRFA therapy (n=58/75). The primary outcomes of interest included the proportion of patients with at least a 50% reduction in numeric rating scale (NRS) pain score at 12 months. Secondary outcomes of interest included the change in Oxford Knee Score (OKS), the global perceived effect of improvement, opioid consumption, and the incidence of adverse and serious adverse events. Follow-up was performed at 12 months from the point of randomization; patients who crossed-over to CRFA at 6 months were therefore monitored for another 6 months. Results demonstrated that 65% of patients in the CRFA group and 49% of patients in the cross-over group experienced a minimum 50% reduction in NRS pain score from baseline. Moreover, NRS pain scores and OKS scores were significantly improved from baseline in the CRFA and cross-over group. The mean opioid consumption was not significantly different from baseline in the CRFA group. Also, 75% of patients in the CRFA group and 57% of patients in the cross-over group perceived an improvement in health at final follow-up. A total of 81 adverse events were observed in the CRFA group between 6 and 12 months, and 4 patients reported serious adverse events.