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Knee radiofrequency ablation
How genicular nerve RFA eases long-standing knee arthritis pain without surgery
Knee radiofrequency ablation (also called genicular nerve RFA) uses gentle heat on the small sensory nerves that carry pain signals from the knee. It may be considered for knee pain that has lasted three months or more, often from osteoarthritis, when therapy, medicine and injections have not given lasting relief, or when surgery is not wanted or not an option. A numbing test block of those nerves comes first. If it clearly eases your usual pain, ablation can calm the nerves for about six to twelve months, sometimes longer, and it can be repeated.
Long-standing knee pain can have several possible causes, including osteoarthritis, a degenerative meniscus, problems behind the kneecap, inflammation of the joint lining, and pain that persists after a knee replacement. A physician examines the knee and reviews X-rays or other imaging to sort out which causes fit. When the pain comes from a worn joint that is not a good fit for surgery, or you want to put surgery off, knee radiofrequency ablation targets the nerves that carry the pain rather than the joint itself. In the first three videos, Ashley Marcus, MD shows how the procedure is done.
Who knee radiofrequency ablation may help
- Chronic knee pain from arthritis, lasting three months or more; see knee arthritis treatment
- People who have tried physical therapy for knee pain, weight management and medicine without lasting relief
- People whose relief from a cortisone shot in the knee or a gel injection is wearing off sooner
- People who are not candidates for a knee replacement, or want to delay it; see alternatives to knee replacement
- Some people with ongoing pain after a knee replacement, once the surgeon has checked the implant
It treats pain signals, not the joint itself, so it does not rebuild cartilage or fix a mechanical problem like a locking knee.
The genicular nerve block comes first
Before ablation, your physician performs a test block: a small amount of numbing medicine is placed next to the genicular nerves around the knee, guided by ultrasound or X-ray. You then keep track of your usual pain over the next several hours. If walking, stairs or standing clearly feel better while the medicine works, those nerves are likely carrying the pain, and ablation is more likely to help. The genicular nerve block and radiofrequency ablation page explains both steps.
What happens during the procedure
- You lie on your back with a small pillow under the knee; the skin is cleaned and numbed
- Using fluoroscopy (live X-ray) or ultrasound, the physician places thin needles next to the target nerves, commonly three around the knee
- A brief test confirms the position, then each nerve is numbed
- Radiofrequency heat is applied for a minute or two at each spot
- You rest briefly and go home the same day, with someone to drive you
Pain procedures are performed at all three offices, and your physician explains where and when yours will be scheduled.
Results and recovery
Soreness or bruising around the knee for a few days is common, and a small patch of skin may feel numb or sensitive for a while. Relief tends to build over two to four weeks and often lasts six to twelve months or longer; because the nerves slowly regrow, the procedure can be repeated if the pain returns. The pain-free window is the time to build strength and walking tolerance with physical therapy at our Brooklyn and Staten Island offices. Our guide to radiofrequency ablation recovery covers the first days and weeks, and lumbar radiofrequency ablation explains the same idea for the lower back.
More videos: knee RFA step by step
More clips from our YouTube channel @precisioncaremedical showing how genicular nerve RFA is planned and performed.
Related care at Precision Care Medical & Sports Performance
Knee radiofrequency ablation near you
Looking for knee RFA near me, or a knee pain doctor near me? Precision Care Medical & Sports Performance evaluates chronic knee pain at all three offices, where our pain physicians, Ashley Marcus, MD in Brooklyn, Jake Stephen, DO on Staten Island and Yuri Gordin, MD in Manhattan review your exam and X-rays and decide whether a genicular nerve block and ablation fit. Our Brooklyn pain management office on Shell Rd is close to Sheepshead Bay, Midwood and Marine Park.
Our Staten Island pain management office on Richmond Rd serves Dongan Hills, Great Kills and Eltingville. In Manhattan, the Precision Care Spine & Pain Center in Midtown Manhattan is a short trip from Midtown East, Turtle Bay and the Upper East Side, and reachable from Spanish Harlem. Request an appointment or call the office closest to you.
150 E 55th St, Suite 401, New York, NY 10022
(212) 840-0135
Questions patients ask
Is knee radiofrequency ablation painful?
The skin is numbed first, and most people feel pressure and some warmth. Soreness around the knee for a few days is common.
How long does knee radiofrequency ablation last?
Relief often lasts six to twelve months and sometimes longer. The nerves slowly regrow, so the procedure can be repeated if the pain returns.
Why is a genicular nerve block done before knee RFA?
The block shows whether the genicular nerves are carrying your pain. If numbing them clearly eases your usual pain, ablation is more likely to help.
Can knee RFA delay a knee replacement?
For some people it eases pain enough to put surgery off, but it does not repair the joint. Your physician and surgeon help you weigh the options.
When can I walk after knee radiofrequency ablation?
Most people walk out the same day and return to light activity within a day or two. Avoid hard workouts for a few days, as your physician advises.
Where can I get knee radiofrequency ablation near me?
Precision Care Medical & Sports Performance evaluates knee pain and plans genicular nerve blocks and ablation at all three offices:
- Brooklyn2781 Shell Rd, Suite 101, Brooklyn, NY 11223(718) 648-1234 · Get directions
- Staten Island1630 Richmond Rd, Suite 101, Staten Island, NY 10304(718) 339-7100 · Get directions
- Midtown Manhattan150 E 55th St, Suite 401, New York, NY 10022(212) 840-0135 · Get directions
Physical therapy for the knee is offered at the Brooklyn and Staten Island offices only.
Educational only, not medical advice. These videos and this article explain common problems and treatments in general terms. They are not a diagnosis or a treatment plan for you. Results vary from person to person. See a qualified clinician about your own symptoms, and call 911 or go to an emergency room for an emergency.
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