Laser Denervation versus PRP for Late-Stage Knee Osteoarthritis: A Prospective Controlled Study

Background: Knee osteoarthritis (OA) is a prevalent degenerative joint disorder characterized by chronic pain and functional impairment. While minimally invasive treatments like platelet-rich plasma (PRP) injections and genicular nerve denervation are used for advanced stages, their comparative efficacy requires further investigation. Objective: To compare the effectiveness and safety of intra-articular PRP injections and laser genicular nerve denervation (LGND) in patients with late-stage knee OA. Methods: In this prospective, randomized, controlled trial, 31 patients with Kellgren-Lawrence grade 3-4 gonarthrosis were allocated to either a single intra-articular injection of autologous PRP (n=16) or a percutaneous LGND procedure (n=15) targeting the superomedial, superolateral, and inferomedial genicular nerves under combined x-ray and ultrasonographic guidance. The primary outcomes were the change from baseline in Visual Analog Scale (VAS) pain scores and the Oswestry Disability Index (ODI) at 2 weeks, 3 months, and 6 months post-procedure. Results: The LGND group demonstrated a statistically significant and greater reduction in both VAS and ODI scores at all follow-up intervals compared to the PRP group. No serious adverse events were reported in either group throughout the 6-month study period. Conclusion: For patients with late-stage knee osteoarthritis, laser genicular nerve denervation provides superior and sustained pain relief and functional improvement over a single intra-articular PRP injection, with a comparable safety profile over six months.