Inclusion Criteria:  Patients with intractable knee pain intensity >5 on an 11-point visual analog scale (VAS) (where 0=no pain and 10=worst pain imaginable) for longer than three months and unable to do knee replacement surgery. Age > 50 years. Grade 2 or 3 KOA based on the Kellgren-Lawrence classification. Patients who did not respond to conservative treatment (physiotherapy, oral NSAIDs, and/or intraarticular injections of hyaluronic acid and corticosteroid) for 3 months. Duration of knee pain ≥ 3 months. Numeric rating scale (NRS) ≥ 5 points within 24 h prior to admission.  Exclusion Criteria:  Grade 1 or 4 KOA based on the Kellgren-Lawrence classification. Severe liver, kidney, cardiovascular, and respiratory disease. Abnormal blood coagulation. Skin infections in the puncture region. Patients who previously underwent knee arthroscopy, TKA, RFTGN, or IAPRF. Mental disorders or inability to complete the follow-up observational form.