Transcutaneous Pulsed Radiofrequency Application Plus Genicular Nerve Block Versus Intraarticular Hyaluronic Acid Injection for Management of Chronic Pain in Knee Osteoarthritis.

Inclusion Criteria: * Aged above 40 years. * Both sexes * American Society of Anesthesiologists (ASA)physical status I and II. * Patients radiologically proven symptomatic knee joint osteoarthritis not responding to medical treatment. * Patients with knee pain of moderate or greater intensity on most or all days for ≥ 3 months, showing significant radiological osteoarthritis (Kellgren-Lawrence grade 1 to 3). Radiological severity was assessed using the Kellgrenand Lawrence global scale as follow: Grade 0; means absence of radiological finding; grade 1: suspected narrowing of joint space; grade 2 refers to osteophytes and possible narrowing; grade 3 is defined as multiple os-teophytes, definite narrowing of joint space and grade 4 comprises large osteophytes, marked narrowing of joint space. Exclusion Criteria: * Patient refusal. * Patients who show improvement on medical treatment, patients on an oral, topical, or intra-articular steroid during the 4 weeks before the study; patients with an oral, topical, or suppository non-steroidal anti-inflammatory drugs within 2 weeks before the study. * Patients having secondary knee osteoarthritis. * Patients with severe osteoarthritis.(K/L grade \>3) in a location other than the knee joint. * Patients with rheumatoid arthritis. * Patients with joint replacement surgery in either knee and/or a hip. * Patients with meniscal tear, ligament injury, bursitis, and popliteal cyst and blood investigations suggestive of any infection. * Morbid obese patients (body mass index (BMI) of \>40 kg/m2) * Infection at site of injection. * Bleeding diathesis and coagulopathy.