Radiofrequency Genicular Nerve Ablation

What is radiofrequency nerve ablation?

Radiofrequency nerve ablation (RFA) is a minimally invasive procedure developed to treat pain by using high-energy radio waves to heat, and therefore destroy certain nerves that transmit painful sensations. RFA is typically only performed on sensory nerves, which are nerves that do not supply the muscles, so joint and muscle function remain unaffected.

In knee osteoarthritis, the nerves that are targeted are the genicular nerves that surround the knee joint.

How is RFA performed?

Having RFA is typically a two-step process. First, you will need to have a genicular nerve block to assess if RFA is likely to help. This is done by injecting a local anaesthetic into one or more of the genicular nerves and assessing if there is any improvement in your pain. If there is, this is a strong indication that RFA is likely to help. The second step is to then undergo the RFA procedure itself. This is performed by inserting a small probe through a needle next to the target nerve(s). The probe then emits radio waves which denervate the target nerve. Both procedures are done as day surgeries under light sedation.

Effectiveness

A recent review by Conger and colleagues in 2021 found that genicular nerve RFA was a safe and effective treatment for knee osteoarthritis pain based on available research. Patients can expect up to a 75% improvement in pain which may be sustained for up to a year following the procedure.

Be Aware

There are risks associated with any interventional procedure. For this reason invasive treatments such as radiofrequency nerve ablation should only be considered in patients who have tried other less invasive treatment options.

Potential risks from radiofrequency nerve ablation include:

• Nerve damage
• Infection
• Bleeding
• A reaction to any of the local anaesthetic or sedation medications used during the procedure

References

Conger et al. (2021). Genicular Nerve Radiofrequency Ablation for the Treatment of Painful Knee Osteoarthritis: Current Evidence and Future Directions. Pain Medicine, 22(S1), S20-S23.