• Matthew Rong Jie Tay, Nimish Mittal, Samantha Yao, and Jordan Farag.
• Toronto Rehabilitation Institute, University Health Network, Toronto, Canada.
• Pain Med. 2024 Oct 30.

ObjectiveChemical neurolysis of the genicular nerves is a treatment option for intractable non-cancer knee pain. This scoping review synthesizes the available literature on the effectiveness, adverse effects and procedural techniques of chemical neurolysis of genicular nerves for the management of knee pain.DesignScoping review.SettingAll clinical and research settings.SubjectsAdult participants with chronic non-cancer knee pain undergoing chemical neurolysis of genicular nerves.MethodsA literature search in MEDLINE, EMBASE and Cochrane Library was conducted up to 4 September 2023. Articles were searched via terms and keywords relating to "knee", "pain", "knee osteoarthritis", "ablation", "alcohol", "phenol" and "chemical neurolysis". Included articles were full text primary studies and in English. Data was extracted using an electronic database by 2 independent reviewers.ResultsThere were 8 studies included in this review (including 1 randomized controlled trial), comprising 192 patients. There were 4 studies that used phenol, 3 studies that used alcohol, and 1 study that used either alcohol or phenol for chemical neurolysis. Both fluoroscopy and/or ultrasound guidance were utilized for nerve target identification. All studies demonstrated that chemical neurolysis resulted in improved pain and/or functional outcomes, with no serious adverse events reported.ConclusionsChemical neurolysis of the genicular nerves is a promising treatment strategy for chronic knee pain. Interpretation of the available studies are limited by study heterogeneity and small sample sizes. High-quality randomized controlled trials are required to clarify the selection of appropriate nerve targets, choice of image guidance, and to compare with other ablative modalities.© The Author(s) 2024. Published by Oxford University Press on behalf of the American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

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