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Genicular (Knee Joint) Nerve Ablation

Pain Treatment Centers of America offers a variety of minimally invasive pain treatment procedures that we have perfected to help you achieve pain relief. Our treatments have been proven effective and are on the cutting edge of science related to pain reduction. Our goal is to improve every patient’s overall function and thus restore a better quality of life.

Overview:

Severe knee pain is a very common compliant in people suffering from osteoarthritis as well as failed knee surgery (pain remaining after knee surgery). Genicular nerve block/neurotomy is a cutting edge technique used to treat severe knee pain that has failed other treatment options. The genicular nerves are the nerves that provide sensation and pain into the knee joint. There are typically 3 branches targeted with genicular nerve block – the superior medial, the superior lateral, and the interior medial genicular nerves.

Conditions commonly treated with genicular nerve blocks:

  1. Severe Osteoarthritis – arthritis in the knee join from wear and tear type injury
  2. Chronic Knee Pain
  3. Degenerative Joint Disease of the knee
  4. Patients with pain after total or partial knee surgery
  5. Patients with chronic knee pain who are not surgical candidates

The procedure:

(please refer to our Pre-procedure Instructions for specifics)

Please arrive 20 minutes prior to your appointment on procedure day. Our nurses will start an IV if you are requesting sedation and take a pre-operative nurse assessment. All patients are taken to the procedure room on a hospital bed. Once in the procedure room, you will be given sedation to help make you comfortable. A cold cleaning solution will be placed on your skin to help decrease chances of infection. The procedure site is then identified by your doctor under x-ray guidance. Once the site is identified a shot of numbing medicine (typically bupivicaine) will be given to numb up the skin. This may feel like a bee sting, but will only last a few seconds. The spinal needle is then placed into the position using x-ray guidance. Medication consisting of steroid (methylprednisilone) and local anesthetics (bupivicaine) is injected through the needle. This medication spreads around and bathes the nerves. Most patients report some pain relief almost immediately. The needle is then removed and you will be taken to the recovery room. The procedure itself takes 10-15 minutes and then you will be observed for another 15 minutes after the procedure. You may then go home and enjoy the rest of your day.

Post Procedure Instructions

What to expect after procedure:

You may notice some swelling or pain around the injection site, but should also notice that your typical knee pain is substantially less. The effects of the nerve block can last from a few hours to a few days. We tell most patients to take it easy the rest of the day, but you may return to normal activities as soon as you feel ready. If the nerve block is successful and your knee pain is substantially reduced, you are able to use less pain medication and you find yourself able to do more activity with less pain, then the nerve block is successful. Once you have successful nerve block your doctor will schedule you for the neurotomy (nerve deadening). This is a very similar procedure as above expect rather than numbing and blocking the nerve, the doctor will deaden the nerve with a special needle. This relief may last anywhere from 6 months to two years.

Risks:

Genicular nerve block/neurotomy is considered an appropriate non-surgical treatment for many patients who suffer from this type of pain. The procedure itself is very safe and has minimal risks. The risks are typically low, but can include misplacement of the needle, bleeding, infection, drug allergy, nerve damage and/or worsening pain. These are exceedingly rare.

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