How Genicular Neurotomy Can Help Treat Arthritic Knee Pain


Arthritis makes your joints stiff, achy, and painful to move. If you have arthritis in your knee, you may have difficulty doing simple tasks, such as sitting down in a chair, getting up, and walking.

Pain medications help subdue inflammation and give you pain relief, but they may stop working over time or cause too many unpleasant side effects. Joint injections may also help, but must be repeated frequently and get expensive over time.

That’s why our founder, Brian Fuller, MD, and the team at Mountain Spine & Pain Physicians in Denver, Colorado, are always on the lookout for new pain treatments that can give our patients relief over the long term. If you have knee pain from arthritis, you might benefit from a minimally invasive nerve ablation procedure called genicular neurotomy.

How your nerves get on your nerves

Whenever you experience pain, the sensation starts in your nerves. Degraded tissues, inflammation, and bone-on-bone friction irritate the genicular nerves in your knee so that they send pain signals to your brain.

As the signal reaches your brain, your brain translates it into pain. If you stop the pain signal, you won’t feel the pain anymore, even if you still have arthritis, a pinched nerve, or damaged tissue.

Although Dr. Fuller recommends regenerative therapies such as stem-cell therapy and platelet-rich plasma (PRP) therapy to restore damaged tissue, insurance doesn’t cover the expense of treatment, putting those important options out of reach for many patients. In addition, regenerative therapies take time to work, because they enhance your body’s own healing and rebuilding processes.

When you’re in pain, you need relief now. If you haven’t been able to control your pain with other options — including pain medications, corticosteroid injections, or hyaluronic acid injections — genicular neurotomy (GN) may be your answer.

Fast relief

You don’t have to undergo general anesthesia or spend time in the hospital to get long-lasting relief from GN. Dr. Fuller offers either local anesthesia or moderate intravenous (IV) sedation, which keeps you awake but drowsy. Both options control your pain so that you’re comfortable throughout the entire procedure.

Once your knee is numb, Dr. Fuller inserts a narrow cannula (i.e., tube) near the area of your nerve. He watches the procedure with fluoroscopic guidance (which is a type of X-ray) to be sure he reaches the nerve or nerves that cause your pain. He makes sure that the only tissue ablated is the aberrant nerve, and not nearby muscle fibers, by testing your motor stimulation in that area.

After he verifies that he’s reached the right nerve, he administers more local anesthetic to dull the nerve so you won’t feel pain when he destroys it. He then sends radiofrequency (RF) energy through the cannula for 90 seconds to ablate the targeted nerve.

Recovery is brief

You can go home immediately after your GN. You might feel a little sore for about a week around the treatment area. However, after that time you’ll notice that you can move your knee without pain or with significantly reduced pain.

Because GN destroys the nerve that sent pain signals, your relief is long-lasting. Many patients who receive GN find that they continue to feel pain relief after one year. If your pain returns, Dr. Fuller may recommend another GN.

You can use GN as a standalone treatment for knee arthritis. If you’re interested in regenerative therapies, but aren’t quite ready for them, you may choose GN to control your pain in the meantime.

To get relief from knee pain caused by arthritis, contact us for a GN consultation by phone at 303-355-3700. You can also request an appointment using our handy online form.

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