Dr. Tural's health blog

Genicular Radiofrequency Ablation for Knee Pain Relief

Knee pain can be debilitating condition, affecting your quality of life and mobility. For those who have exhausted conservative treatments like medications and physical therapy without success, Genicular Radiofrequency Ablation (Genicular RFA) can offer significant relief. In this article, we’ll explore what genicular radiofrequency ablation is, its indications, the procedural steps involved, potential complications, and contraindications.

What is Genicular Radiofrequency Ablation?

Genicular radiofrequency ablation is used to ablate the nerves responsible for transmitting pain signals from the knee joint to the brain. During this minimally invasive procedure, radio waves generated by a radiofrequency device are used to destroy the nerves with the heat generated at the tip of the radiofrequency needle. It is a promising option for those with chronic knee pain that has not responded well to other treatments. Genicular radiofrequency ablation aims to provide long-term pain relief by interrupting these pain signals.

Genicular nerve radiofrequency ablation -knee pain

Indications for Genicular RFA

Individuals meeting the following criteria may be candidates for Genicular RFA:

  • Those suffering from symptomatic knee osteoarthritis (OA) that remains unresponsive to conservative treatments.
  • Individuals with a history of unsuccessful knee replacement surgery, where the exact cause of persistent pain in the region of the total knee arthroplasty remains undetermined.
  • Patients who are not suitable candidates for surgery due to underlying medical conditions and/or a high body mass index.
  • Those who prefer non-surgical alternatives to manage their knee pain.
  • Patients who have previously undergone a successful genicular nerve radiofrequency ablation, as this procedure can be repeated to address recurrent symptomatic knee OA.


GRA may not be suitable for everyone and contraindications include

How is Genicular RFA performed?

GRA is a multi-step procedure that includes preoperative, intraoperative and postoperative phases.

Preoperative phase

A consultation will be conducted by a physician, who will evaluate the individual’s medical history, perform a physical examination, and review relevant imaging studies such as X-rays or MRI scans. Informed consent will be provided to the patient, ensuring they are well-informed about the procedure, its potential risks and benefits, and giving them the opportunity to ask questions.

Intraoperative phase

The patient will be positioned on the procedure table to optimize access to the knee. Medications, such as sedation or local anesthesia, may be administered to ensure the patient’s comfort during the procedure. Imaging techniques such as fluoroscopy or ultrasound will be used by the doctor to accurately identify the target nerves. 

A specialized radiofrequency needle will be inserted through the skin near the genicular nerves. The doctor will assess the pain by stimulating the nerves to determine that the needle is in the right place. Then, with the help of the radiofrequency device, by creating heat at the tip of the inserted needle, a lesion is created in the genicular nerves during a period of 60 – 120 seconds. After the ablation procedure, a mixture of local anesthetic and corticosteroid, usually in a volume of 1-2ml, is injected into the lesioned area.

Postoperative phase

Monitoring patients for a short period is standard procedure to ensure their stability and comfort. In most cases, patients can return home on the same day, but it is essential for them to arrange for someone to provide transportation. Patients may experience some discomfort over the next few days, which should gradually improve. Physicians will schedule follow-up appointments to monitor the patients’ progress.

Complications of Genicular RFA

While the risk of infection at the procedure site is usually very low, however, it is a potential complication that individuals should be aware of. Although rare, there is the possibility of unintentionally damaging nearby nerves during the procedure, which can lead to temporary or permanent complications. Some patients may experience temporary discomfort or swelling at the procedure site, which should gradually subside in the days following the Genicular RFA.

Genicular RFA is a promising treatment option for chronic knee pain in patients who haven’t found relief through conservative methods. It offers a minimally invasive way to target and alleviate knee pain, providing an improved quality of life. However, it’s essential to discuss the procedure, its risks, and benefits thoroughly with your doctor to determine if Genicular RFA is the right choice for you.