The goal of this clinical trial is to compare the efficiency and efficacy of genicular nerves blockade by chemical phenol neurolysis versus radiofrequency ablation in managing pain in patients suffering from grade IV KOA in term of NRS pain score.
The participants will be evaluated by numeric rating scale and oxford knee score for assessment of pain relief up to 16 weeks.
Grade 4 knee osteoarthritis according to Kellgren-Lawrence radiological classification.
Failure to manage pain with conservative methods.
Prior knee replacement
Patients with cardiac pacemakers or implantable cardiac defibrillators.
Septic knee or systemic sepsis.
Allergy to any of the drugs used in the study.
Parallel
genicular nerve neurolysis
Procedure/SurgeryThe superior medial genicular nerve (SMGN), superior lateral genicular nerve (SLGN), and inferior medial genicular nerve (IMGN) will be blocked either by phenol neurolysis or radiofrequency ablation
Numeric rating scale
By an independent physician pain will be recorded using numeric rating scale which is a screening tool used to assess pain severity using a 0 - 10 scale with zero meaning no pain and 10 meaning the worst pain ever.
oxford knee score
This score is used to assess both function and pain of the knee on a scale ranging from 0 (worst pain and function) and 48 (best function and no pain) this score will be recorded by an independent physician
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