Patient Perspectives on Radiofrequency Treatment for Chronic Knee Pain: A Qualitative Study Embedded in the COGENIUS-Trial

Abstract

Background: The COGENIUS trial is an ongoing double-blinded randomized trial evaluating the effectiveness, cost-effectiveness, and safety of radiofrequency (RF) of the genicular nerves, an emerging minimally invasive treatment for chronic knee pain due to osteoarthritis (OA). Objectives: This qualitative study, embedded within the COGENIUS trial, explored how individuals with knee OA perceive their current treatment options, including RF. Design & Methods: Twelve semi-structured interviews were conducted with COGENIUS participants diagnosed with therapy-resistant knee OA pain of >= 1 year. The sample included seven males and five females (mean age of 66 years, SD 10.5). An interpretive paradigm and descriptive qualitative design guided data collection and analysis. Setting: 17 Belgian hospitals Results: Participants described a substantial burden of knee OA, characterized by pain, functional limitations, sleep disturbances, and emotional impact. Treatment trajectories were long, heterogeneous, and often inconsistent with guideline-based care. RF was perceived as feasible, acceptable, and credible in the setting of the COGENIUS trial. Sedation was considered important to minimize discomfort. The run-in phase was generally seen as offering little added value. Participants emphasized functionality alongside pain as key treatment outcomes. They were open to targeting multiple genicular nerves to improve treatment effectiveness and expressed willingness to repeat the procedure. Conclusions: This qualitative study highlights the substantial burden of knee OA and the variability of treatment trajectories in Belgium Participants regarded genicular nerve RF as a meaningful option for therapy-resistant knee pain, particularly when sedation is tailored to individual needs. Their perspectives provide direction for optimizing RF delivery, enhancing patient education, and informing future research, including studies with larger samples, clinician input, and qualitative evaluation of RF in persistent postsurgical knee pain.