Introduction: Knee osteoarthritis (OA) has become a worldwide health issue. Genicular nerve ablation has been used for the management of pain in knee osteoarthritis patients. This study aims to compare between fluoroscopy and ultrasound-guided genicular ablation.

Patients and methods: A total of 30 cases were included, and they were divided into two groups, 15 cases underwent the fluoroscopic guided procedure, while the other 15 cases underwent the ultrasound-guided procedure. Both VAS and WOMAC scores were assessed and recorded in all cases after 1-, 3-, and 6-month follow-up visits.

Results: Patient demographics and characters did not differ significantly between the two groups. Both groups showed a marked improvement of both scores when compared to their basal score. However, the ultrasound group showed a marked improvement compared to fluoroscopy.

Conclusion: Based on our study findings, we believe that ultrasound-guided genicular verve ablation provides better results compared to the fluoroscopic guided procedure. However, fluoroscopy still provides an effective guidance method.