400 Section - Indications for Genicular Nerve Radiofrequency Ablation After Total Knee Arthroplasty: A Retrospective Case Series

Tuesday, May 19, 2026

6:00 PM - 7:30 PM PT

Presenting Author/Autor expositor(s)

FF

Faris Z. Fazal, BS

Medical Student
Oregon Health & Science University
Tigard, Oregon, United States

Corresponding Author/Autor a quien dirigir la corr(s)

JD

Jesse R. Day, MD

Assistant Professor of Physical Medicine and Rehabilitation
Oregon Health & Science University
Portland, Oregon, United States

Objectives : Persistent pain after total knee arthroplasty (TKA) is common, and frequently the source of pain is not well understood. Genicular radiofrequency ablation (RFA) has become increasingly used for chronic post-TKA pain, but it is still unclear what pain patterns and patient characteristics are most typical. This project aims to describe the clinical indications, patient characteristics, and outcomes of genicular RFA after TKA.

Design: Retrospective review of patients who underwent genicular RFA for post-TKA pain at a single academic center between 2024-2025. Variables included demographics, pain onset/duration, pain location, comorbidities, time between arthroplasty and RFA, and pain etiology categories divided into six groups. Findings were summarized descriptively.

Results: Twelve patients met inclusion criteria (10 women, 2 men). Mean age at TKA was 66.4 ±8.2 years, and mean age at RFA was 71.0 ±10.0 years. Mean BMI was 29.5 ±6.4 kg/m². The median interval between TKA and RFA was 33 months (range:18-141), and the median pain duration before RFA was 31 months (range:18-134). Pain onset was immediate after TKA in 10 patients (83%), and anterior knee pain was most common (8 patients, 67%). Psychiatric comorbidities were present in 11 patients (92%), and metabolic comorbidities in 9 patients (75%). Etiologies included mechanical/structural pain in 4 patients (33%), idiopathic pain in 3 (25%), postoperative complications in 3 (25%), and arthrofibrosis in 2 (17%). Follow-up RFA outcomes showed 9-of-11 (82%) reported >50% pain improvement, while 2-of-11 (18%) reported minimal or no benefit (< 50%).

Conclusion: Genicular RFA was effective and well tolerated for persistent post-TKA pain. Several post-arthroplasty pain etiologies were identified, and most patients experienced >50% improvement, suggesting a role for RFA across different post-TKA pain profiles. These early results support its use as a non-operative option. Larger studies are needed to improve patient selection, identify response predictors, and determine which pain presentations benefit most.