Genicularnerve Ablation (RF NEUROTOMY)

During this outpatient procedure, the physician uses a radio frequency device to heat up and disrupt the genicular nerves. These are the sensory nerves that transmit pain signals from the knee to the brain. Disrupting these pathways can provide long term relief from knee pain.

What is RFA?

Radiofrequency ablation is an outpatient procedure that uses a special needle to heat and desensitize nerves that transmit pain signals. This results in long-lasting pain relief, between nine to 12 months in 90% of patients. To know if you’re a good candidate for an RFA, a diagnostic block must first be performed using a local anesthetic to identify the pain generator. Positive diagnostic blocks show 80 to 100 percent relief of pain for the first eight to 12 hours.

RFA is a treatment option for neck pain, low back pain, sacral/hip/buttock pain, knee pain, and occipital neuralgia.

This procedure uses heat from radio waves to treat painful facet joints in your neck. It eases pain that isn't helped by medications or physical therapy.

This procedure uses heat from radio waves to treat painful facet joints in your lower back. It eases pain that isn't helped by medications or physical therapy.

What to expect afterwards?

Your doctor and staff will explain what to expect before, during, and after the treatment. If you want sedation for your procedure, your doctor will advise you to avoid eating or drinking anything for eight hours before the procedure and to have a responsible adult drive you home. You are welcome to do the procedure awake under local anesthesia if you would prefer. You may need to stop taking certain medicines (blood thinners) several days before your procedure.

All our procedures are performed in the sterile operating room using image guidance. You will first be comfortably positioned and monitors to check your vital signs will be placed. Oxygen will be given to you if you get sedation. After a sterile cleaning of the site to be injected, sedation will be given if desired. Then local anesthesia will be used to numb the skin. The needle will be placed using image guidance. Once the procedure is finished, needles are removed and bandages will be placed. You will be taken to the recovery room until you are ready for discharge home.

Why does an RFA last nine to 12 months?

RFA uses heat to desensitize the nerve. It leaves the outer architecture of the nerve intact while causing the proteins inside the nerve to degrade. As the nerve regenerates itself over 12 months, the pain may return and the RFA can be repeated. RFA is a covered procedure by all insurance including Medicare.

What are the risks?

Risks of an RFA include bleeding, infection, nerve injury and neuroma formation when the nerve regrows.These risks are reported to be 1-2%. The procedure is performed in a sterile operating room using image guidance by a board certified expert to mitigate these risks.