Is genicular nerve radio frequency ablation the key to improving patients’ satisfaction after total knee arthroplasty? a randomised controlled trial

Abstract Background Some studies regarding patients complaining of residual pain after total knee arthroplasty (TKA) showed pain scores improvement using genicular nerve radiofrequency ablation (GNRFA). This prompted the hypothesis that combining GNRFA with TKA intraoperatively might improve early postoperative pain control and functional outcomes. Methods Seventy patients were randomly assigned into two groups, one group underwent total knee arthroplasty combined with genicular nerve radiofrequency ablation (TKA-GNRFA), and the other group underwent total knee arthroplasty (TKA) alone. A parallel-group trial with 1:1 allocation using a superiority framework, Visual Analog Scale (VAS), and functional outcome using the Oxford Knee Score (OKS) were evaluated. Assessments were conducted during the first six months following surgery. Results There were no significant differences in pain score or functional outcome between the two groups in the first six months postoperative follow-up period. Conclusion At Six months postoperatively, Combining Genicular Nerve radiofrequency ablation with total knee arthroplasty (TKA-GNRFA) showed no significant advantage regarding pain scores and functional outcome over performing TKA alone. Further randomized controlled trials with larger sample sizes are recommended to provide higher-level evidence and validate these findings. Trial Registration Retrospectively registered under Trial Registration Number NCT07381062 on 24-01-2026.