Review of genicular artery embolization, radiofrequency ablation, and cryoneurolysis in the management of osteoarthritis-related knee pain

Osteoarthritis (OA) of the knee represents one of the most common diseases in the world, affecting an estimated 14 million people in the United States alone. Exercise therapy and oral pain medication are first-line treatments but have limited efficacy. Next-line treatments such as intra-articular injections are limited in durability. Moreover, total knee replacements, although effective, require surgical intervention, which has considerable variability in patient satisfaction. Novel minimally invasive image-guided interventions are becoming more widespread for treating OA-related knee pain. Recent studies of these interventions have revealed promising results, minor complications, and reasonable patient satisfaction. In this study, published manuscripts were reviewed in the field of minimally invasive, image-guided interventions for OA-related knee pain, with a focus on genicular artery embolization, radiofrequency ablation, and cryoneurolysis. Recent studies have demonstrated a significant decrease in pain-related symptoms following these interventions. Reported complications were mild in the reviewed studies. Image-guided interventions for OA-related knee pain exist as valuable options for patients who fail other therapies, may not be good surgical candidates, or wish to avoid surgical intervention. Further studies with randomization and an increased length of follow-up are needed to better characterize outcomes following these minimally invasive therapies.