Cooled Radiofrequency at Five Revised Targets for Short-Term Pain and Physical Performance Improvement in Elderly Patients with Knee Osteoarthritis: A Prospective Four-Case Reports.

BACKGROUND AND

objectivesOsteoarthritis (OA) is a common cause of chronic pain. In refractory cases, cooled radiofrequency (CRF) of the genicular nerves is indicated. However, recent studies suggest that traditional targets may be insufficient, proposing the inclusion of the recurrent fibular nerve and the infrapatellar branch of the saphenous nerve. This study reports a prospective four-case series evaluating short-term outcomes of CRF at five revised targets in elderly Brazilian patients. CASE REPORT: The study (CAAE No.: 55647722.5.0000.5142) included four patients (three women, one man; mean age 73.8 years) with moderate to severe refractory knee pain underwent diagnostic nerve block followed by ultrasound-guided CRF. After 30 days, three patients reported pain reduction, including two who experienced substantial improvement. One patient maintained severe pain. Improvements in physical performance, knee flexion, and extension were observed in patients who responded clinically, while individuals with coexisting myofascial pain showed limited functional gains. One patient experienced mild transient pruritus. In this prospective case series, CRF applied to five revised targets appeared feasible and well tolerated, with short-term improvement in pain and function in some patients. These preliminary descriptive findings support further investigation in larger controlled studies.