Geniculate Nerve Cryoanalgesia for Chronic Knee Pain: A Retrospective Study
Abstract
Francesco Saturno, Giulia Monaco, Angela Salerno, Antonio Cianciola, Carmine Secondulfo and Emidio Cianciola
Background: Knee osteoarthritis represents one of the leading causes of disability in older adults. Minimally invasive percutaneous treatments, including cryoanalgesia of the geniculate nerves, are emerging as valid alternatives for patients who are not candidates for surgery or who do not respond to infiltrative therapy.
Objectives: To evaluate the safety and medium-term efficacy of geniculate nerve cryoanalgesia in patients with refractory knee pain.
Methods: A retrospective review of all cryoanalgesia procedures performed on geniculate nerves between 2023 and 2024 was conducted. Pain outcomes (VAS) were collected at 6 months and 1 year. Complications and need for repeat procedures were recorded.
Results: Fifty patients were included. At 6 months, 86% (n=43) reported VAS <3. Seven patients experienced pain recurrence; four underwent repeat cryoanalgesia, with only one maintaining VAS >5. At 1 year, nine patients reported recurrence, and five of them underwent a repeat procedure, all reporting VAS <5. No major complications occurred. A transient increase in pain during the first 7–10 days was reported in a minority of cases.
Conclusion: Cryoanalgesia of the geniculate nerves is a safe and promising minimally invasive technique for managing refractory knee pain in high-risk or non-surgical candidates. Larger prospective studies are needed to assess long-term outcomes and potential opioid-sparing effects.