12-Month Efficacy of the Pull-Back Technique for Genicular Nerve Ablation for Knee Osteoarthritis

Wednesday, April 2, 2025

10:30 AM – 10:39 AM CT

Location: Music City Center, 207 AB

Presenting Author(s)

Aazrin Mir, MS (she/her/hers)

Medical Student
Georgetown University School of Medicine, United States

Author/Co-author(s)

Neil K. Jain, DO (he/him/his)

Integrated Interventional Radiology Resident
Medstar Georgetown University Hospital, United States
TS

Thomas Stirrat, BS, BA

Medical Student
Georgetown University School of Medicine, United States
Keith M. Horton, MD, FSIR (he/him/his)

Professor of Clinical Radiology
MedStar Washington Hospital Center/ Georgetown University School of Medicine , United States
GS

Gajan Sivananthan, MD

Assistant Professor of Radiology
MedStar Washington Hospital Center, United States
AK

Arshad Khan, MD

Attending
MedStar Washington Hospital Center, United States
Nora Tabori, MD (she/her/hers)

Associate Professor
MedStar Washington Hospital Center, United States
John B. Smirniotopoulos, MD, MS

Assistant Professor of Radiology
MedStar Georgetown University Hospital, United States

Purpose:

The pull-back technique (pbGNA) is an option for genicular nerve ablation for knee osteoarthritis, accounting for demonstrated anatomic variability in the location of the superomedial and superolateral genicular nerves in cadaveric and MRI studies. This study evaluates the efficacy of pbGNA after one year using Visual Analog Scale (VAS) and Western Ontario McMaster Universities Osteoarthritis Index (WOMAC) scores for pain and functionality. This is further compared to the one year outcomes for the traditional genicular nerve ablation technique (tGNA).

Materials and Methods:

A single-center retrospective analysis of a prospectively collected cohort of patients who underwent GNA between September 2022 and August 2023 was performed. Baseline and 12-month post-procedure VAS and WOMAC scores were collected and analyzed for tGNA and pbGNA.

Results:

51 patients (12 male, 39 female, mean age 63.5) underwent 40 tGNA and 20 pbGNA. tGNA patients had a mean BMI of 37.5, baseline VAS of 8.54, follow-up VAS of 7.3, baseline WOMAC of 62.4, and follow-up WOMAC of 56.9. pbGNA patients had a mean BMI of 35.9, baseline VAS of 8.35, follow-up VAS of 5.3, baseline WOMAC of 70.9, and follow-up WOMAC of 42.6. There was a significant overall reduction in VAS (p < 0.0001) and WOMAC (p = 0.004) for all patients, and a statistically significant difference in the 12 month VAS score for pbGNA compared to tGNA (p = 0.0045).

Conclusion:

The pull-back technique results in a significant decrease in both VAS and WOMAC scores at 12 months, and a significant decrease in VAS scores compared to tGNA, making it an effective option for genicular nerve ablation for pain related to knee osteoarthritis.