Chronic knee pain affects a significant number of adults, often impacting daily activities and overall quality of life. This persistent discomfort can stem from various causes, including conditions like osteoarthritis or previous injuries. When conventional treatments do not provide sufficient relief, knee ablation offers an alternative.
Understanding Knee Ablation
Knee ablation is a procedure designed to alleviate chronic knee pain by targeting specific nerves responsible for transmitting pain signals to the brain. These nerves, known as genicular nerves, are located around the knee joint and are primarily sensory.
The most common method is radiofrequency ablation (RFA). This technique uses radio waves to generate heat, creating a small lesion on the targeted genicular nerves. This disrupts their ability to send pain signals. An alternative, cryoablation, uses extreme cold to temporarily block nerve function by freezing the tissue.
Who Is a Candidate?
Knee ablation is generally considered for individuals experiencing chronic knee pain that has not responded well to more conservative treatments. This often includes patients with persistent discomfort due to conditions such as osteoarthritis. It may also be an option for those who have undergone knee surgery, including knee replacement, but continue to experience pain.
Individuals who are not suitable candidates for knee replacement surgery, or those wishing to postpone it, might also consider knee ablation. Before the ablation procedure, a diagnostic nerve block is typically performed. This involves injecting a numbing medication near the genicular nerves to confirm they are the pain source. A significant reduction in pain, often 50% or more, after this test injection generally indicates a good candidate for the full ablation procedure.
The Ablation Procedure
The knee ablation procedure is minimally invasive and typically performed on an outpatient basis. It usually begins with a local anesthetic to numb the area. Imaging guidance, such as fluoroscopy or ultrasound, is then used to precisely locate the genicular nerves. This guidance is important for accurate needle placement and to ensure the correct nerves are targeted.
Once the nerves are precisely identified, a specialized needle or probe is inserted through the skin and guided to the target nerve locations. For radiofrequency ablation, radiofrequency energy is delivered through the probe, creating a controlled heat lesion that disrupts the nerve’s ability to transmit pain signals. The entire procedure generally takes approximately 20 to 60 minutes.
What to Expect After Ablation
Following a knee ablation procedure, patients can typically return home the same day. Some soreness, bruising, or mild discomfort at the needle insertion sites is common and can last for a few days to a couple of weeks. Applying ice packs to the treated area can help manage these sensations.
While some immediate pain reduction might be noticed due to the local anesthetic, the full pain-relieving effects typically become apparent within a few days to three weeks. Pain relief from knee ablation can last for several months, often ranging from six to twelve months. The treated nerves can eventually regenerate, meaning the pain relief may not be permanent, and the procedure can be repeated if needed. Potential side effects can include temporary numbness in the treated area or a temporary increase in pain.