{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T01:05:31Z","timestamp":1793235931385,"version":"4.5.0"},"reference-count":39,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2025,6,24]],"date-time":"2025-06-24T00:00:00Z","timestamp":1750723200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,1,1]]},"abstract":"Abstract<\/jats:title>\n \n Importance<\/jats:title>\n Knee osteoarthritis (OA) is a prevalent and disabling condition, especially in older adults. For patients who are not candidates for total knee arthroplasty (TKA) due to comorbidities or limited access to care, minimally invasive pain-relief options are critically needed.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To assess the efficacy and safety of ultrasound-guided chemical neurolysis using 95% ethanol targeting four genicular nerves in patients with symptomatic knee OA who have not responded to conservative management.<\/jats:p>\n <\/jats:sec>\n \n Design<\/jats:title>\n Double-blind, randomized, sham-controlled clinical trial.<\/jats:p>\n <\/jats:sec>\n \n Participants<\/jats:title>\n A total of 100 adults with symptomatic knee OA, confirmed radiographically and unresponsive to conservative treatment, were enrolled and randomized.<\/jats:p>\n <\/jats:sec>\n \n Interventions<\/jats:title>\n Patients were randomized to receive ultrasound-guided chemical neurolysis of the superomedial, superolateral, recurrent tibial, and inferomedial genicular nerves with 95% ethanol (treatment group) or a sham procedure (control group).<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n The primary outcome was pain intensity measured by the Numerical Rating Scale (NRS) at 7 days, 30 days, 3 months, and 6 months post-procedure. Secondary outcomes included opioid consumption and health-related quality of life measured by the EQ-5D-5L questionnaire. Safety outcomes focused on the occurrence of neurological complications. Analyses were conducted using an intention-to-treat approach with appropriate handling of missing data.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Patients in the ethanol neurolysis group experienced significantly greater reductions in NRS scores at all follow-up points compared to the sham group (P\u2009&lt;\u2009.0001). Opioid consumption was also significantly reduced in the neurolysis group throughout the 6-month period (P\u2009&lt;\u2009.0001). Quality of life, as assessed by EQ-5D-5L, improved significantly in the treatment group (P\u2009&lt;\u2009.0001). No neurological deficits or serious adverse events were reported in either group.<\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n Ultrasound-guided chemical neurolysis of the SMGN, SLGN, RTGN, and IMGN with 95% ethanol is a safe and effective minimally invasive treatment for patients with refractory knee OA pain. It significantly reduces pain and opioid use while improving quality of life, making it a valuable therapeutic option for individuals ineligible for surgical intervention.<\/jats:p>\n <\/jats:sec>","DOI":"10.1093\/pm\/pnaf081","type":"journal-article","created":{"date-parts":[[2025,6,24]],"date-time":"2025-06-24T07:41:19Z","timestamp":1750750879000},"page":"33-42","source":"Crossref","is-referenced-by-count":2,"title":["Effect of ultrasound-guided genicular nerve neurolysis versus sham procedure on pain in patients with knee osteoarthritis: a randomized clinical trial"],"prefix":"10.1093","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9067-0969","authenticated-orcid":false,"given":"Malgorzata","family":"Reysner","sequence":"first","affiliation":[{"name":"Department of Palliative Medicine, Poznan University of Medical Sciences , 61-701 Pozna\u0144,","place":["Poland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4565-9880","authenticated-orcid":false,"given":"Tomasz","family":"Reysner","sequence":"additional","affiliation":[{"name":"Department of Palliative Medicine, Poznan University of Medical Sciences , 61-701 Pozna\u0144,","place":["Poland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3206-4426","authenticated-orcid":false,"given":"Grzegorz","family":"Kowalski","sequence":"additional","affiliation":[{"name":"Department of Palliative Medicine, Poznan University of Medical Sciences , 61-701 Pozna\u0144,","place":["Poland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3392-1813","authenticated-orcid":false,"given":"Aleksander","family":"Mularski","sequence":"additional","affiliation":[{"name":"Department of Forensic Medicine, Institute of Medical Sciences Collegium Medicum, University of Zielona G\u00f3ra , 65-417 Zielona G\u00f3ra,","place":["Poland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7738-6023","authenticated-orcid":false,"given":"Przemyslaw","family":"Daroszewski","sequence":"additional","affiliation":[{"name":"Department of Organization and Management in Health Care, Poznan University of Medical Sciences , 61-701 Pozna\u0144,","place":["Poland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4017-3013","authenticated-orcid":false,"given":"Katarzyna","family":"Wieczorowska-Tobis","sequence":"additional","affiliation":[{"name":"Department of Palliative Medicine, Poznan University of Medical Sciences , 61-701 Pozna\u0144,","place":["Poland"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,6,24]]},"reference":[{"issue":"6","key":"2026012109015165600_pnaf081-B1","doi-asserted-by":"crossref","first-page":"568","DOI":"10.1001\/jama.2020.22171","article-title":"Diagnosis and treatment of hip and knee osteoarthritis: a review","volume":"325","author":"Katz","year":"2021","journal-title":"JAMA"},{"issue":"4","key":"2026012109015165600_pnaf081-B2","doi-asserted-by":"crossref","first-page":"481","DOI":"10.3892\/etm.2023.12180","article-title":"Knee osteoarthritis: current status and research progress in treatment","volume":"26","author":"Geng","year":"2023","journal-title":"Exp Ther Med"},{"issue":"7","key":"2026012109015165600_pnaf081-B3","doi-asserted-by":"crossref","first-page":"4042","DOI":"10.1097\/MS9.0000000000002214","article-title":"A brief review of current treatment options for osteoarthritis including disease-modifying osteoarthritis drugs (DMOADs) and novel therapeutics","volume":"86","author":"Jiang","year":"2024","journal-title":"Ann Med Surg"},{"issue":"4","key":"2026012109015165600_pnaf081-B4","doi-asserted-by":"crossref","first-page":"262","DOI":"10.5114\/ait.2023.132832","article-title":"Standards of perioperative management in total knee and hip arthroplasty procedures. 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