PhD defence Amy Belba

Keywords: Radiofrequency ablation, Genicular nerves, Osteoarthritis, Persistent postsurgical knee pain

"Targeting the genicular nerves for chronic knee pain: a multidimensional analysis"

This doctoral thesis evaluated genicular nerve interventions for chronic knee pain using a mixed-methods, patient-centred approach structured by the JBI FAME framework. Across five studies conducted between 2017 and 2026, radiofrequency treatment showed meaningful benefits for pain and patient-reported outcomes in therapy-resistant knee osteoarthritis and persistent postsurgical pain, although patient selection and placebo effects remain important considerations. Preliminary economic findings suggest that cooled radiofrequency may be more cost-effective in postsurgical pain, while conventional radiofrequency may be preferable in osteoarthritis. The treatment was generally well tolerated, with relatively few, mostly temporary adverse events, although rare serious complications require attention. The thesis also explored genicular nerve blocks for acute perioperative pain and showed promising potential within enhanced recovery pathways. Qualitative findings indicated that patients consider radiofrequency acceptable and meaningful. Overall, genicular nerve interventions should be integrated into broader, personalised knee pain care pathways rather than used as stand-alone treatments in routine care.

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