Genicular Artery Embolization and Genicular Nerve Radiofrequency Ablation for Knee Osteoarthritis: A Systematic Review of Sham-Controlled Randomized Trials
Muhammad Farrell Rikhad1*, Abimanyu Awanda Ragil1, Fariz Albarri2
Abstract
Symptomatic knee osteoarthritis (KOA) may persist despite conservative care, and arthroplasty is not suitable for every patient. Genicular artery embolization (GAE) and genicular nerve radiofrequency ablation (RFA) target different proposed sources of knee pain. Because invasive procedures can produce substantial contextual responses, this review examined only sham-controlled randomized controlled trials (RCTs). PubMed, ScienceDirect, Europe PMC, and OpenAlex were searched for English-language reports published from January 2016 to June 2026. Eligible trials enrolled adults with symptomatic KOA and compared GAE or genicular nerve RFA with a sham procedure. Outcomes included pain, function, global improvement, analgesic use, imaging findings, and adverse events. Risk of bias was assessed with Cochrane Risk of Bias 2, and the evidence was synthesized narratively. Four RCTs randomized 221 participants. In the two embolization trials, pain improved in both active and sham groups, without significantly greater pain relief after GAE at 12 months; one exploratory analysis favored complete embolization for selected secondary outcomes. The two RFA trials differed: bipolar ablation of three genicular nerves was no better than sham RFA with local anesthetic and steroid at 12 months, whereas cooled RFA produced higher pain-responder rates than sham at 1, 3, and 6 months. No serious procedure-related complications were reported. The available sham-controlled evidence does not show a durable pain benefit of GAE beyond the sham response, whereas cooled RFA has the clearest evidence of short-term analgesic efficacy, although results vary by technique. Direct comparative trials with standardized procedures and longer follow-up are required.
Keywords
knee osteoarthritis; genicular artery embolization; genicular nerve radiofrequency ablation
Cite This Article
Rikhad, M. F., Ragil, A. A., Albarri, F. (2026). Genicular Artery Embolization and Genicular Nerve Radiofrequency Ablation for Knee Osteoarthritis: A Systematic Review of Sham-Controlled Randomized Trials. International Journal of Scientific Advances (IJSCIA), Volume 7| Issue 6: Nov – Dec 2026, Pages 1000-1007. URL: https://www.ijscia.com/wp-content/uploads/2026/11/Volume7-Issue6-Nov-Dec-No.1122-1000-1007.pdf
Volume 7 | Issue 6: Nov – Dec 2026
