The goal of this prospective randomized control trial is to provide continued pain relief, classically long-lasting 3 to12 months, and enhanced function in patients following: both gender; male and female, age group; >50yr, healthy volunteers along with Radiographic diagnosis of knee OA with KL grade 3 and 4 in addition of Chronic knee pain ≥ 6 months and patients with ≥50% decrease in pain strength after diagnostic genicular nerve block. The main question it aims to answer is:

Is ultrasound-guided genicular nerve RFA more efficient in lowering pain intensity at six months contrasted with fluoroscopic guided method in patients with chronic knee osteoarthritis? Researchers will compare Group A (Fluoroscopic) to Group B (Ultrasound) to see comparison in efficiency of ultrasound guided against fluoroscopic guided genicular nerves block for decrease in pain intensity and functional improvement.

Inclusion Criteria:

• Both gender patients of age more than 50 years.
• Radiographic diagnosis of knee OA with KL level 3 and 4.
• Chronic knee pain for more than 6 months
• Patients with more than 50% reduction in pain intensity after diagnostic genicular nerve block

Exclusion Criteria:

• Lack of consent
• surgery of knee
• Patient with BMI more than 40kg/m2
• Intra-articular steroid injection or hyaluronic acid in last 3 months
• Localized infection at procedure site or knee.
• Patient unable to communicate properly (Severe psychiatric illness, severe dementia and cognitive impairment).
• Patients have moderate to severe low back pain (NRS ≥5)