Clinical trial: Fluoroscopic Versus Ultrasound Guidance for Cooled Radiofrequency Ablation of Geniculate Nerves in Knee Osteoarthritis: A Randomized Control Trial (NCT04472702)

Eligibility criteria:
Inclusion Criteria:

          -  1) patients of either gender with primary knee OA of one or both knees fulfilling the
             diagnostic criteria for knee OA by the American College of Rheumatology,

          -  2) Kellgren-Lawrence score of two to four,

          -  3) reported NPRS pain intensity of at least four on most or all days of the past week

          -  4) pain resistant to conventional treatments which may include but is not limited to
             medications (e.g. acetaminophen, oral or topical non-steroidal anti-inflammatory
             drugs, opioids), physical therapy, and intra-articular injections (e.g.
             corticosteroids, hyaluronic acid, platelet-rich-plasma) for at least 3 months. In the
             case of bilateral knee OA, the most symptomatic knee will be treated and studied.

        Exclusion Criteria:

          -  1) age <35 years,

          -  2) non-English speaking patients,

          -  3) body mass index greater than 40,

          -  4) previous radiofrequency ablation procedure for the knee,

          -  5) active systemic or local infections at the site of needle/cRFA probe placement,

          -  6) previous knee joint replacement surgery,

          -  7) autoimmune or inflammatory cause of knee arthritis such as rheumatoid or psoriatic
             arthritis,

          -  8) non-ambulatory patients,

          -  9) patients who are unable to provide their own consent (e.g. dementia),

          -  10) unstable medical or psychiatric illness,

          -  11) patients with pacemakers, spinal cord stimulators, deep brain stimulators, or
             similar devices,

          -  12) patients seeking care as a part of workman's compensation or have litigation
             pending

          -  13) a negative response to diagnostic geniculate nerve lidocaine injections.
No condition on gender to be admitted to the trial.
No healthy subjects accepted to join the trial.
Subject must be at least 35 Years old.
Subject must be at most 99 Years

Patient description (medical language): A 47-year-old woman comes to the office complaining of pain in the calf and knee when she bends down. The pain limits her activity. Her medical history is significant for osteoarthritis, for which she uses nonsteroidal anti-inflammatory drugs (NSAIDs) for the past two years. She is living with her husband and has 3 children. She doesn't smoke but drinks alcohol occasionally. Her vital signs are normal. On physical examination, there is a small effusion in the right knee. The effusion grew a little larger and she developed a tender swelling in the popliteal fossa and calf. Both the pain and swelling worsened as she bent and straightened her knee.

Patient description (patient's own words): I'm a 47-year-old woman, married with 3 kids. I don't smoke and I drink occasionally. I went to the doctor because of pain in my calf and knee when I was bending down. This has been limiting my daily activities. I have been diagnosed with osteoarthritis for which I have taken anti-inflammatory drugs for the past 2 years. The doctor saw a small fluid buildup in my right knee. This buildup became a bit bigger and I have a swollen calf. The pain is worse when I bend and straighten my knee.

Does the patient match the trial criteria? Entailment