To mitigate symptoms associated with KOA, CRFA (Cooled radiofrequency ablation) and HA (Hyaluronic acid) injections are two commonly used modalities. The study comparing CRFA to a single HA injection depicted that a significant number of KOA patients treated with CRFA illustrated sustained knee pain relief for at least 12-months. 

A prospective randomized multi-center study aimed to explore the efficacy of CRFA for curing KOA pain at 12 months. It also evaluated patients treated with HA who crossed over to CRFA after 6-months of treatment.

The study recruited 177 KOA patients (n = 89 CRFA, n = 88 HA) with follow-ups at 1, 3, 6 and 12 months. HA subjects with inadequate outcomes at 6-months were permitted to crossover and receive CRFA. Knee pain (NRS; numeric rating scale), WOMAC Index (pain, stiffness and physical function), overall quality of life (GPE; global perceived effect, EQ-5D-5 L; Health-Related Quality of Life Questionnaire), and adverse events were estimated.

At 12-months, 65.2% of subjects in the CRFA group witnessed a ≥50% pain reduction from baseline. In the crossover cohort, a total of 64.5% participants reported ≥50% pain relief from baseline, with a mean NRS pain score of 3.0 ± 2.4 at 12 months as depicted in the figure:

The mean NRS pain score measured was 2.8 ± 2.4 at 12 months compared to a baseline of 6.9 ± 0.8, illustrating a 4.1 decrease in NRS pain score as depicted in the following table:

Participants in the CRFA cohort witnessed a 46.2% improvement in total WOMAC score at the 12-month time point. After receiving CRFA, subjects in the crossover cohort witnessed a 27.5% improvement in total WOMAC score. A remarkable improvement in the quality of life was witnessed in all subjects receiving CRFA. No serious adverse events were witnessed related to either procedure. Overall, the adverse event profiles were similar between CRFA, HA, and crossover cohorts.

For the management of KOA, CRFA provides extended clinical utility.