NICE guidance supports option to use radiofrequency denervation for osteoarthritic knee pain

14 August 2023

 

Clinicians have received guidance from the National Institute for Health and Care Excellence (NICE) in England to offer radiofrequency denervation to treat patients who have osteoarthritic knee pain1. The guidance provides a minimally invasive treatment option for patients where treatment falls into using supportive footwear, walking aids, painkillers, or going for surgery. Radiofrequency denervation is a procedure that destroys nerves from sending pain signals by heating the nerve with an electrical current. 

Osteoarthritis is a disease that prevents people from being active due to pain and stiffness in their joints. It is the most common form of arthritis in the UK, affecting over 8 million people.2 NICE, which provides recommendations to improve health and social care, reviewed the evidence on the safety and efficacy of radiofrequency denervation. It  concluded that there is good evidence to show that radiofrequency ablation relieves pain in the short term, there are no major safety concerns, and the complications are well recognised. NICE also recommends the treatment method should only be performed by clinicians with specific training and experience in this procedure.

“NICE’s approval of radiofrequency ablation of the genicular nerve of the knee validates the effectiveness of this procedure which will help with wider introduction of this injection to the invasive portfolio of pain service treatment,” said Dr Tomasz Bendinger, consultant in Pain and Anaesthesia at Sheffield Teaching Hospitals NHS Foundation Trust.“It can be a suitable option for patients with milder osteoarthritis who are not a candidate for surgical intervention and conservative management is not fully satisfactory. This procedure, together with multimodal management, can potentially postpone the need for many joint replacement surgeries.”   

Osteoarthritic knee pain tends to affect adults over the age of 55 in the UK. In studies specifically focused on the knee, at least half of all older adults with knee pain report some restriction of daily activity.3 Women are more likely than men to develop osteoarthritis. According to Arthritis Research UK, 18% of the UK population aged over 45 years sought treatment for osteoarthritis of the knee.4

“Data in the UK shows that one in 10 adults have symptomatic clinically diagnosed osteoarthritis with knee pain being one of the most common reported.5 We welcome the NICE guidance because radiofrequency denervation provides physicians and patients with an alternative minimally invasive treatment that significantly reduces pain, improves functionality and quality of life of the patient,” said Vincent Sourdaine, vice president of Neuromodulation in Europe, Middle East, and Africa at Boston Scientific. “Medtech innovation in radiofrequency denervation is demonstrating that this technique can alleviate costs on healthcare systems that would otherwise perform knee replacement surgery.”

 

References

  1. NICE guidelines
  2. Osteoarthritis (plymouthhospitals.nhs.uk)
  3. Knee pain and osteoarthritis in older adults: a review of community burden and current use of primary health care | Annals of the Rheumatic Diseases (bmj.com)
  4. Arthritis Research UK (2013) Osteoarthritis in general practice. Arthritis Research UK. https://www.versusarthritis.org