Effect of ultrasound-guided genicular nerve neurolysis versus sham procedure on pain in patients with knee osteoarthritis: a randomized clinical trial.
OrthoEvidence Journal (OE Journal) - ACE Report
Epub Ahead of Print
Pain Med. 2026 01-Jan;():. 10.1093/pm/pnaf081What this means for my practice?
Ultrasound-guided ethanol genicular nerve neurolysis provides significant and sustained pain relief while reducing opioid use in patients with refractory KOA. Clinically, this supports its role as a viable non-surgical treatment option. Key limitations include the single-centre design and limited long-term follow-up beyond 6 months.
Study Summary
One hundred patients with symptomatic knee osteoarthritis (KOA) were randomized to receive ultrasound-guided genicular nerve neurolysis with 95% ethanol or a sham procedure. The primary outcome of interest was pain intensity measured by the Numerical Rating Scale (NRS). Secondary outcomes included opioid consumption, quality of life (EQ-5D-5L), and safety outcomes such as neurological complications. Outcomes were assessed at 7 days, 30 days, 3 months, and 6 months post-procedure. Overall, the results of the study revealed that the neurolysis group had significantly greater reductions in pain, opioid use, and improved quality of life compared to sham at all time points. These findings suggest that ethanol-based genicular nerve neurolysis is an effective and safe minimally invasive option for managing refractory KOA pain.
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