Comparison of percutaneous and conventional radiofrequency applications for the treatment of knee osteoarthritic pain: a randomized controlled trial

BACKGROUND: Radiofrequency (RF) therapy has emerged as a potential intermediary treatment option for knee osteoarthritis (OA). The current research evaluated the efficacy of percutaneous and conventional RF treatments for knee OA pain. METHODS: In this randomized controlled trial, 50 participants with knee OA were allocated equally to receive either percutaneous (Group P) or conventional (Group C) RF treatment. Patients were assessed at baseline, one, four, and 12 weeks post-procedure. RESULTS: Preprocedural Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores and Visual Analog Scale (VAS) scores were similar between groups. While both improved, Group C showed consistently better function and pain relief, with significant differences at week 12 (WOMAC: 43.12±10.43 vs. 36.12±11.96, P=0.032; VAS: median 2 vs. 1, P=0.010). Patient satisfaction was initially similar but significantly higher in Group C by week 12 (median 2 vs. 3, P=0.002). Adverse events were minimal, with subcutaneous bleeding being the most common (36% in Group P, 52% in Group C). No serious complications were reported. CONCLUSIONS: Although percutaneous RF is minimally invasive with few complications, conventional RF showed superior outcomes at 12 weeks, with significantly better WOMAC scores, lower VAS pain ratings, and higher patient satisfaction. Thus, conventional RF may be a more effective option for sustained symptom relief in knee OA. Morover, Percutaneous RF may serve as an option for short-term pain relief and can be repeated in cases where conventional RF is unavailable or contraindicated.