Genicular nerves anatomy : from accuracy of anatomical landmarks to the treatment of knee osteoarthritis pain by genicular nerve blockade and radiofrequency ablation

The treatment of chronic knee osteoarthritis pain remains a challenge. In recent years, genicular nerve blockade (GNB) and radiofrequency ablation (RFA) have emerged as promising alternatives, as they have several advantages over other conservative therapies. However, anatomical accuracy is critical in order to ensure a successful outcome. Despite the recent popularity of these techniques, there are many discrepancies on the innervation of the knee capsule and neural targets for GNB and RFA. This PhD thesis investigates the anatomical distribution of the nerves supplying the knee joint capsule, determines the neural targets and accurate anatomical landmarks for GNB and RFA, and validates new technique for fluoroscopic and ultrasound-guided GNB and RFA. Then, it compares the currently used technique with classical anatomical targets, to the above-developed new technique that uses revised targets, on cadavers first, then in patients suffering from chronic knee pain.