Saphenous Nerve Pulsed Radiofrequency Ablation for Chronic Knee Pain: A Case Series with Preliminary Results

Background: Chronic knee pain due to osteoarthritis is a leading cause of disability in older adults and presents a growing burden as the population ages.While conservative treatments and genicular nerve ablation offer relief for many, a subset of patients continue to experience refractory symptoms.Pulsed radiofrequency ablation (P-RFA) of the saphenous nerve at the adductor canal has emerged as a potential intervention for patients with persistent medial knee pain, yet its clinical efficacy remains underexplored.Methods: Patients with refractory knee pain related to osteoarthritis who received RFA of the saphenous nerve at the adductor canal if they had previously failed conservative measures, including genicular radiofrequency ablation were extracted from institutional data.Patients received ultrasound-guided RFA of the saphenous nerve using a 20 g 3.5 inches RFA probe.Baseline demographics, numeric rating scale (NRS) pain scores, and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) physical functional scores were recorded at baseline and at follow-up visits at 3 and 6 months.Patient improvement and minimal clinically important difference (MCID) was analyzed at each follow up.Results: A total of 12 patients were included.The average NRS pain intensity was significantly reduced from baseline to 4.2 1.8 after 3 months (P < 0.0001) and 3.0 1.0 after 6 months (P < 0.0001).The average WOMAC physical function was significantly improved from baseline to 29.3 7.5 after 3 months (P < 0.0001) and 20.3 6.7 (P < 0.0001) after 6 months.Of our 12 patients, 42% reached the minimal clinically important difference (MCID) in NRS pain improvement after 3 months, and 83% after 6 months.Regarding the WOMAC function score, 17% reached the MCID after 3 months, and 75% after 6 months. Conclusions:This case series contributes to the body of literature suggesting RFA of the saphenous nerve at the adductor canal may be a successful treatment option for chronic knee pain related to osteoarthritis refractory to conservative measures.