What is genicular nerve ablation?

The genicular nerve is located in the knee; it can be the culprit behind chronic knee pain that has been difficult to treat. Genicular nerve ablation involved using radiofrequency to heat up the genicular nerve until it dies, causing relief of pain in about a week. It may be a treatment option for chronic knee pain sufferers for whom conventional therapy has been unsuccessful.

Am I a candidate for genicular nerve ablation?

You are a candidate for genicular nerve ablation if you have significant chronic knee pain that is not caused by a torn ligament, cartilage, or bone fracture and did not improve with medications or physical therapy. Additionally, you will undergo a diagnostic genicular nerve block prior to the ablation. A genicular nerve block involves injecting a numbing medication into you knee right next to the genicular nerve. If this improves your pain by at least half – that is, if your pain was an 8/10 prior to the injection and 4/10 or less after the injection, then you are a candidate. This means that losing feeling in the genicular nerve will be beneficial to you. You are not a candidate for genicular nerve ablation if you have an infection in your blood or on the skin or tissues around your knee. Be sure to tell your doctor if you have any implanted electrical devices (a pacemaker, for example) prior to the procedure or if you are allergic to contrast dye.

How long will genicular nerve ablation procedure take?

The genicular nerve ablation does not take long. Your knee will be cleaned and numbed with a local anesthetic injected into the skin. This may sting briefly. Once the site is prepared, your provider will use an ultrasound machine or fluoroscopy (real-time x-ray machine with contrast dye) to see the inside of your knee. A needle will be inserted into the knee joint and lidocaine, the numbing medicine your dentist injects into your gums prior to filling a cavity, is injected near the genicular nerve. This may require more than one injection. You will be asked about your pain; if it improves by at least half, then you are a candidate for ablation of the genicular nerve. The catheter is then heated to a specific temperature for a couple of minutes to burn the genicular nerve.

How long will it take to recover from genicular nerve ablation?

Recovery from genicular nerve ablation is minimal. You will likely experience some soreness or pain in your knee for a few days. Take it easy the day of the procedure and let your pain be your activity guide. You should be able to return to work the following day. It may take up to a week to experience full pain relief. The genicular nerve will regenerate eventually; your pain may or may not come back. If your pain goes away but returns after months, you can undergo the genicular nerve ablation again.

Reference:

Bolash, R, and M. Schaefer. (2016). Genicular nerve radiofrequency ablation for select patients with persistent pain. Cleveland Clinic. Retrieved from https://consultqd.clevelandclinic.org/2016/06/genicular-nerve-radiofrequency-ablation-select-patients-persistent-pain/