Genicular Nerve Block Versus Genicular Nerve Ablation for Knee Osteoarthritis: A Systematic Review of Randomized Controlled Trials and Retrospective Studies

Abstract

This systematic review aimed to compare the efficacy and safety of genicular nerve ablation and genicular nerve block (GNB) in pain control and functional improvement in knee osteoarthritis (OA) patients using a systematic review of randomized controlled trials (RCTs) and retrospective studies. We searched PubMed, Google Scholar, Cochrane, Science Direct, and Web of Science using specific keywords until April 2023. The primary outcome measures were visual analog scale (VAS) and numerical rating scale (NRS) scores for pain. The secondary outcome measures included functional outcomes assessed by the Western Ontario and McMaster Universities Arthritis Index (WOMAC) score and complications. Four RCTs and two comparative studies met the inclusion criteria. The analysis revealed that both genicular nerve ablation and nerve block effectively reduced pain and improved functionality. Ablation possibly provided more substantial and long-lasting effects than diagnostic blocks. However, the superiority of ablation compared to therapeutic block with steroids is still not conclusive in pain reduction. Functional capacity improvements were comparable between ablation and therapeutic block. Adverse events were minimal and transient.