Procedure Description
Genicular nerve blocks and radiofrequency ablation (RFA) are minimally invasive procedures used to treat chronic knee pain, especially when surgery is not an option or has failed to provide relief. These procedures target the genicular nerves—small sensory nerves surrounding the knee joint responsible for transmitting pain signals to the brain.
The treatment is performed in two stages:
A diagnostic genicular nerve block to determine whether the genicular nerves are the source of pain.
If the block provides significant pain relief, a radiofrequency ablation is performed to burn (ablate) the nerve endings, providing longer-lasting relief.
What It Treats
Genicular nerve blocks and RFA are commonly used to manage:
Chronic knee pain due to osteoarthritis
Post-surgical knee pain, including after total knee replacement (TKR)
Non-surgical candidates for knee replacement
Persistent knee pain not responsive to physical therapy, medications, or injections
Pain from ligament or meniscal injury, especially when surgery is not feasible
How It Is Performed
Stage 1: Diagnostic Genicular Nerve Block
The skin around the knee is sterilized and numbed with local anesthetic.
Using fluoroscopy (X-ray) or ultrasound, small needles are inserted near three key genicular nerves: the superior medial, superior lateral, and inferior medial genicular nerves.
A small amount of local anesthetic is injected near each nerve.
You will be monitored over the next 24–48 hours to assess pain relief.
If you experience significant (typically ≥50%) reduction in pain, you may be a candidate for RFA.
Stage 2: Genicular Nerve Radiofrequency Ablation
Similar positioning and imaging guidance are used.
A special RFA needle is placed at each targeted nerve location.
After confirming proper placement, a radiofrequency current is applied to heat and deactivate the nerve endings.
The nerves are not removed—they are “turned off” to stop sending pain signals.
The RFA procedure usually takes 30–45 minutes and is done on an outpatient basis.
Pre-Procedure Instructions
Do not eat or drink for at least 6 hours if sedation is planned.
Continue taking medications unless advised to pause blood thinners or certain drugs—follow your provider’s instructions.
Inform your provider if you:
Are pregnant or breastfeeding
Have an allergy to local anesthetics or contrast dye
Have a bleeding disorder or infection
Arrange for a driver if sedation is used or if knee strength is affected post-procedure.
Wear loose, comfortable clothing
