radio frequency treatment knee pain

knee-arthritis radiofrquency treatment

genicular neurotomy*

dr sanjay sharma

interventional pain physician

JPRC spine & joints care

jaipur

 a condition of pain and inflammation in a joint which leads to restricted joint movements.

 It is perceived to be disease of the old, but can affect people of all ages. There are two types of arthritis – osteoarthritis and rheumatoid arthritis. The symptoms of arthritis are joint pain, stiffness and tenderness.

 Among other arthritis symptoms are weakness, muscle wasting and red skin over the affected joint. As of now, there is no arthritis cure. So, the treatment of arthritis focuses on slowing down the condition. 

Painkillers and anti-inflammatory drugs are advised for easing the complication of arthritis. most oftenly patients keep on trying switching from one medicine to another in hope of complete cure,but as arthritis is chronic disease,remission are inevitable.

non surgical treatment-

it is common in practice that after a long trial with medicine or other available treatment ,patients are advised to adopt for surgical intervention[knee replacement]
but radio frequency ablation now a best non surgical option to avoid untimely,unwanted knee replacement surgery in people,who are not medically fit,or unaffordable.

What is Genicular RF Neurotomy?

Genicular Neurotomy  is a advance new, innovative option for treating any kind of knee pain without  open surgery. that avoid replacement surgery in most of knee pain cases for limited duration,This highly advanced procedure is on the absolute cutting edge of medicine. By selectively applying a sophisticated type of radio frequency wave to the nerves surrounding the knee (the genicular nerves),because most of knee joint structure supply by genicular nerves. one can effectively relieve pain in the knee from different ethology.

what are Indications

for rf neurotomy?

Perhaps the greatest advantage of genicular neurotomy is the fact that the entire procedure is performed OUTSIDE the knee capsule. This is what allows it to succeed where other procedures like cortisone injections, hyaluronic acid injections, and even surgery fail. In fact, this procedure can be done up to one month before knee surgery and even after surgery. 

Genicular neurotomy is indicated for a variety of conditions:

Osteoarthritis (OA)
 Chronic Knee Pain
 Degenerative Joint Disease
 Total Knee Replacement (before or after)
 Partial Knee Replacement (before or after)
 Patients unfit for knee replacement

 Patients who want to avoid a knee replacement

neurotomy is advance procedure,without any  attempt to open surgery,through a guided RF canula under local anaesthesia ,without giving any steroid or other injection,that detrimental to our health.without affecting any joint structure,or any side effects.its one of noble approach to relieve your painful knee.

While surgery is considered to be the accepted treatment option for patients with advanced joint disease, many individuals have comorbidities that may prevent them from being an appropriate surgical candidate. Others may simply want to avoid surgery, as they may be unable to take off the necessary time from work for the procedure and post-operative recovery period. In these cases, radiofrequency neurotomy of the genicular nerves is a safe, potential alternative to joint replacement for pain.

Despite the general efficacy of knee replacements,as every procedure has its own limitations, many patients complain the pain persists even after surgery. In these unfortunate cases, patients have traditionally had few options,either to opt redo surgery or living with pain. if any, that did not involve additional surgery. With the advent of genicular nerve neurtomy, patients can look forward to get pain relief without any replacement surgeries.

How Does It Work?

The procedure uses a breakthrough advance technology called Radiofrequency Ablation (RFA) to slowdown the painful nerves and prevent the signals from reaching the brain. This amazing technology has been used for decades with excellent success, traditionally to treat pain in the neck and back. The nerves grow back over time which makes the procedure reversible if necessary.after few weeks to month nerves get regrow again

RFA harnesses the energy of radio waves to treat pain at the source, without the need for incisions of any kind.  The most appealing aspect of RFA is that there is no need for steroid or cortisone injections, making it ideal for patients with high blood pressure and Diabetes.any patients who supposed to be fit by your surgeon for surgery,can be consider for procedure.

This procedure is performed in two steps:

• Diagnostic Genicular Nerve Block – This procedure consists of placing a small amount of a local anesthetic, like2% Lidocaine or Bupivacaine, on the genicular nerves to test the patient’s response  like sensory or motor and see if there is sufficient enough relief in the knee to justify performing a therapeutic neurotomy.watch for few hours to days .
• Genicular Nerve Ablation – This is the therapeutic portion of the treatment whereby the physician will perform a radiofrequency ablation (RFA) of the genicular nerves, thus alleviating pain to the knee and restoring function.

Both portions of the procedure are performed as an outpatient under direct fluoroscopic guidance or ultrasound guided depending on modalities available to centre or expertise of treating doctor

What Are The Benefits?

It is a minimally invasive day care procedure, nonsurgical treatment option with the aim to relieve pain where other more conventional therapies like pain killers,accupressure ,massage,steroid injections etc have failed. When we compared to a total knee replacement or any replacement surgical intervention.

Genicular Nerve Neurotomy	Traditional Joint Replacement
Inexpensive and covered by most insurance	Can be extremely expensive even with good insurance
Performed in your doctor’s fluoroscopic suite	Performed in hospital
Outpatient procedure	Inpatient admission for few days
Can be done with only local anesthetic	Required general anesthesia and regional anesthesia
Minimal risk of infection	Risk of post-surgical or nosocomial infection
No need for blood thinners	Requires 4 weeks of blood thinners (anticoagulation)
recovery period few hours	Long postoperative recovery period requiring inpatient rehab
In most of cases, can go back to work the same day	Can be weeks to months before returning to work
Little to no postoperative pain, typically controlled with NSAIDs and cold fomentation	Significant postoperative pain
Can return to normal activities in a matter of days	Can be months before returning to normal activities