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The following is a summary of “Genicular Nerve Ultrasound-Guided Cryoanalgesia for the Treatment of Chronic Knee Joint Pain: An Observational Retrospective Study,” published in the March 2025 issue of Pain and Therapy by Bianco et al. 

Chronic knee pain from osteoarthritis (OA) often led to disability, while total knee arthroplasty (TKA) provided relief, many individuals experienced chronic post-surgical pain (CPSP), prompting exploration of minimally invasive techniques like Cryoanalgesia of the genicular nerves (GNCryo) for sustained pain relief.  

Researchers conducted a retrospective study to examine the effectiveness of ultrasound-guided GNCryo in individuals with chronic knee pain due to primary OA or CPSP after TKA.  

They assessed 90 individuals who underwent GNCryo between September 2021 and February 2023. Eligibility required individuals to be over 18 years old, have symptomatic knee OA or CPSP following TKA, and illustrated at least 50% pain relief from diagnostic genicular nerve blocks. Ultrasound guidance was utilized to ensure accurate needle placement and minimize complications. Clinical outcomes were recorded at baseline and at 1-, 3-, 6-, and 9-months post-procedure. Assessments included the Visual Analog Scale (VAS, 0–10) for pain intensity, the Western Ontario and McMaster Universities Arthritis Index (WOMAC, 0–100) for OA-related pain, stiffness, and function, the Douleur Neuropathique en 4 Questions (DN4, 0–10) for neuropathic pain, and the EuroQol 5-Dimension (EQ-5D, 0–100) for QoL.  

The results showed that all 90 individuals completed the 9-month follow-up. The median VAS score declined from 7.0 (6.0, 8.0) at baseline to 4.0 (3.0, 5.0) at 1 and 3 months, then slightly increased to 5.0 (4.0, 5.0) at 6 months and 5.0 (4.0, 6.0) at 9 months, remaining lower than baseline. The WOMAC score dropped from 65 (55, 71) at baseline to 35 (30, 40) at 1 and 3 months, and rose to 40 (35, 50) at 6 months and 55 (45, 65) at 9 months. The DN4 score decreased from 7 (5, 8) at baseline to 4 (3, 4) at 1 month and 3 (2, 4) at 3 months, then increased to 3.5 (3, 5) at 6 months and 5 (4, 6) at 9 months, yet remained below baseline. The EQ-5D score improved from 64.5 (47, 84) at baseline to 42 (32, 58) at 1 month, 43.5 (31, 59) at 3 months, 45.5 (35, 60) at 6 months, and 52 (41, 72) at 9 months.  

Investigators concluded that ultrasound-guided GNCryo was a promising minimally invasive treatment for chronic knee pain, providing pain relief and improved QoL up to 9 months, although some outcomes trended toward baseline over time. 

Source: link.springer.com/article/10.1007/s40122-025-00727-5