{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,9]],"date-time":"2026-11-09T16:47:05Z","timestamp":1794242825868,"version":"4.9.0"},"reference-count":51,"publisher":"BMJ","issue":"4","license":[{"start":{"date-parts":[[2022,12,21]],"date-time":"2022-12-21T00:00:00Z","timestamp":1671580800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Faculty of Medicine Ramathibodi Hospital, Mahidol University"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Reg Anesth Pain Med"],"accepted":{"date-parts":[[2022,11,28]]},"published-print":{"date-parts":[[2023,4]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Variability in anatomy in the knees supports the use of aggressive lesioning techniques such as bipolar-radiofrequency ablation (RFA) to treat knee osteoarthritis (KOA). There are no randomized controlled trials evaluating the efficacy of bipolar-RFA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Sixty-four patients with KOA who experienced &gt;50%\u2009pain relief from prognostic superomedial, superolateral and inferomedial genicular nerve blocks were randomly assigned to receive either genicular nerve local anesthetic and steroid injections with sham-RFA or local anesthetic and steroid plus bipolar-RFA. Participants and outcome adjudicators were blinded to allocation. The primary outcome was Visual Analog Scale pain score 12\u2009months postprocedure. Secondary outcome measures included Western Ontario and McMaster Universities Arthritis (WOMAC) and Patient Global Improvement-Indexes (PGI-I).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Both groups experienced significant reductions in pain, with no significant differences observed at 12 months (reduction from 5.7\u00b11.9\u2009to 3.2\u00b12.6 in the RFA-group vs from 5.0\u00b11.4\u2009to 2.6\u00b12.4 in the control-group (p=0.40)) or any other time point. No significant changes were observed between groups for WOMAC and PGI-I at the primary endpoint, with only the control group experiencing a significant improvement in function at 12-month follow-up (mean reduction from 91.2\u00b138.2\u2009to 67.1\u00b151.9 in the RFA-group (p=0.06) vs from 95.8\u00b141.1\u2009to 60.6\u00b142.8 in the control group (p=0.001); p=0.85 between groups).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Our failure to find efficacy for genicular nerve RFA, coupled with evidence showing that a plenitude of nerves supply the knee joint and preliminary studies indicating superiority of lesioning strategies targeting more than three nerves, suggest controlled trials using more aggressive lesioning strategies are warranted.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration number<\/jats:title>\n                    <jats:p>TCTR20170130003.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/rapm-2022-103976","type":"journal-article","created":{"date-parts":[[2022,12,21]],"date-time":"2022-12-21T11:40:11Z","timestamp":1671622811000},"page":"151-160","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":30,"title":["Bipolar radiofrequency ablation of the superomedial (SM), superolateral (SL) and inferomedial (IM) genicular nerves for chronic osteoarthritis knee pain: a randomized double-blind placebo-controlled trial with 12-month follow-up"],"prefix":"10.1136","volume":"48","clinical-trial-number":[{"clinical-trial-number":"nct04504812","registry":"10.18810\/clinical-trials-gov"}],"author":[{"given":"Wanwipha","family":"Malaithong","sequence":"first","affiliation":[{"name":"Department of Anesthesiology, Phramongkutklao Hospital, Bangkok, 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