Genicular Nerve Radiofrequency Ablation Versus Hyaluronic Acid Injection for Knee Osteoarthritis Pain
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- Who runs it
- Hospital Universitari Joan XXIII de Tarragona.
- Trial code
- NCT07901374
- Record updated
- 28 October 2026
- Original description
The goal of this clinical trial is to learn if thermal radiofrequency ablation of the genicular nerves (the nerves that carry pain signals from the knee) works better than a single injection of hyaluronic acid into the knee to relieve pain in adults with knee osteoarthritis who have not improved with conservative treatment. The study also includes patients with severe knee osteoarthritis who are not candidates for knee replacement surgery.Read full original descriptionShow less
A Prospective Comparative Study of Conventional Conservative Treatment Versus Genicular Radiofrequency Ablation in Non-Surgical Knee Osteoarthritis: A Randomized Controlled Trial of Thermal Radiofrequency of the Genicular Nerves Versus Intra-Articular Hyaluronic Acid
The goal of this clinical trial is to learn if thermal radiofrequency ablation of the genicular nerves (the nerves that carry pain signals from the knee) works better than a single injection of hyaluronic acid into the knee to relieve pain in adults with knee osteoarthritis who have not improved with conservative treatment. The study also includes patients with severe knee osteoarthritis who are not candidates for knee replacement surgery.
The main questions it aims to answer are:
* Does genicular nerve radiofrequency reduce knee pain during movement more than hyaluronic acid over 12 months? * Does it improve knee function and quality of life, and does its effect last longer?
Researchers will compare radiofrequency ablation with hyaluronic acid injection to see which treatment gives greater and longer-lasting pain relief.
Participants will:
* Be randomly assigned to one of the two treatments. * If assigned to radiofrequency, first receive a diagnostic nerve block with local anesthetic. Only those whose pain decreases by at least 50% will then receive radiofrequency ablation, in a single ultrasound-guided session. * If assigned to hyaluronic acid, receive a single injection of hyaluronic acid into the knee. * Attend follow-up visits at 1, 3, 6 and 12 months, where they will rate their pain and answer questionnaires about knee function, overall status and quality of life.
Inclusion: Adults (18 years or older) with symptomatic knee osteoarthritis of more than 6 months' duration; Pain during movement >4 on a 0-10 visual analogue scale; Failure of conservative treatment: pain during movement >4 despite at least 3 months of NSAIDs and/or rehabilitation (physical therapy), documented in the medical record. Patients with a documented contraindication to NSAIDs may be included if they have undergone rehabilitation; Radiographic Kellgren-Lawrence grade II or III, or; Kellgren-Lawrence grade IV in patients who are not candidates for total knee arthroplasty because of at least one of the following: body mass index >39.9 kg/m2; Charlson Comorbidity Index >=5 (original, not age-adjusted); or a documented multidisciplinary decision of the Orthopaedic Surgery Department; Signed informed consent.
Exclusion: Intra-articular hyaluronic acid or corticosteroid injection in the previous 6 months; Major lower limb surgery in the previous 6 months that may affect function or pain of the index knee (including contralateral total or partial knee arthroplasty, hip arthroplasty, or tibial or femoral osteotomy); Acute or chronic knee joint infection; Cardiac pacemaker or metallic implant (contraindication for radiofrequency); Known allergy to hyaluronic acid; Severe dementia; Decompensated systemic disease; Active neurological or inflammatory rheumatological disease; Terminal oncological disease; Coagulopathy or anticoagulant treatment that does not allow a safe therapeutic window for the procedure; Institutionalized patients; Inability to understand the study questionnaires; Radiofrequency arm only: negative diagnostic genicular nerve block (<50% pain reduction within 4 hours).