Knee Genicular Nerve Blocks and Radio Ablation

Overview

Genicular Nerve Block/neurotomy is indeed a relatively new technique used to treat severe knee pain that has not responded to other treatments. This procedure typically targets three branches of the genicular nerve:

1. Superior medial branch
2. Superior lateral branch
3. Inferior medial genicular nerves

By targeting these branches, genicular nerve block/neurotomy aims to provide relief from knee pain and improve the patient’s quality of life.

Genicular Nerve Blocks are commonly used to treat various conditions related to knee pain, including:

1. Knee Osteoarthritis: This type of arthritis occurs due to wear and tear on the knee joint, leading to pain, stiffness, and reduced mobility.
2. Chronic Knee Pain: Chronic knee pain can be caused by various factors such as tendinitis, injury, osteoarthritis, gout, or other underlying conditions.
3. Degenerative Joint Disease: This condition involves the progressive breakdown of joint cartilage and underlying bone, leading to pain and stiffness in the affected joint.
4. Pain after Total or Partial Knee Surgery: Some patients may experience persistent pain after knee surgery, and genicular nerve blocks can be used to manage this pain.
5. Chronic Knee Pain in Non-Surgical Candidates: For patients with chronic knee pain who are not suitable candidates for surgery, genicular nerve blocks can offer pain relief and improve quality of life.

These nerve blocks can provide effective pain relief and improve the overall function of the knee joint for patients suffering from these conditions.

Procedure

Arriving 20 minutes before your appointment on procedure day is advisable. If you request sedation, nurses will start an IV and perform a preoperative assessment. Following the assessment, you will be taken to the procedure room where you will receive sedation to make you more comfortable. A cleaning solution will be applied to your skin to reduce the risk of infection. Your doctor will then identify the procedure site under x-ray guidance. Once identified, a shot of numbing medicine, typically bupivacaine, will be given to numb the skin. Although the shot may initially feel like a bee sting, the sensation will last only a few seconds.

The spinal needle will be placed into position using X-ray guidance, and a medication consisting of a steroid (methylprednisolone) and local anesthetic (bupivacaine) will be injected through the needle. This medication will disperse and bathe the nerves. Most patients report some pain relief almost immediately. The needle will then be removed, and you will be taken to the recovery room. The procedure itself typically takes 10-15 minutes, and you will be observed for an additional 15 minutes after it is complete.

While it is generally recommended that each patient take it easy after a nerve block, you can return to normal activities as soon as you feel ready. It may be preferable to have someone drive you home following the procedure, although it is not a requirement.

What to expect afterwards:

After a Genicular Nerve Block procedure, you may experience mild swelling or pain at the injection site. However, you should also notice a substantial decrease in typical knee pain. Pain relief typically lasts from a few hours to a few days.

A successful Genicular Nerve Block should lessen your pain enough that you don’t require as much pain medication during the day and experience less pain while performing normal activities.

Following a successful nerve block, your pain doctor may schedule a neurotomy (nerve deadening) or radiofrequency ablation procedure.

The process for genicular nerve neurotomy is similar to a nerve block. However, instead of numbing and blocking the nerve, your doctor will deaden it with a special needle. Pain relief from neurotomy can last anywhere from 6 months to two years.