The safety and efficacy of genicular nerve radiofrequency ablation for pain in inferolateral quadrant of the knee

Background: Genicular nerve radiofrequency ablation (RFA) is an effective procedure to alleviate knee pain. This procedure has been proven to be safe, except in the inferior lateral quadrant (ILQ) due to its innervation being near the common fibular nerve (CFN). Given the complexity of this approach, pain physicians do not routinely perform RFA in the ILQ, leading to inadequate pain relief in this region. Methods: This is a retrospective study of 54 patients who had undergone genicular nerve RFA. Thirty patients had genicular nerve RFA of the knee joint including the ILQ innervated by the inferolateral genicular and recurrent fibular nerves, while 24 patients had RFA of the knee joint without involvement of the ILQ. We compared the outcomes (pain relief, function, and complications) in the patients with and without ILQ RFA at 3 months and 6 months after RFA. Results: There was no significant difference in initial pain and functional level before RFA between these two groups. After RFA, the two groups had comparable pain relief at 3 months (p ​= ​0.06) and 6 months (p ​= ​0.20), and similar functionality at 3 months (p ​= ​0.29) and 6 months (p ​= ​0.12). There were no reported complications after RFA with or without ILQ RFA. Conclusions: RFA of the innervation to the ILQ of the knee is as safe and effective as all other anterior quadrants.