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Cooled Radiofrequency Denervation-Hip/Knee

Cooled radio frequency denervation can provide significant pain relief from osteoarthritis of the hip and knee for patients who have not had benefit from lifestyle modifications or relief with simple over-the-counter analgesics. These patients also have not had long-lasting pain relief from injection of medication into the joints. 

This procedure can also be done when pain is unrelieved following joint replacement or when intra-articular injections are no longer recommended. Usually, a diagnostic test will be performed first in which your doctor will place local anesthesia only along the nerves supplying the joint. If you have significant benefit for the length of the local anesthesia, this is considered a positive test, and you would be a candidate for the cooled radiofrequency procedure.  

How It Works

  • Your Center for Pain Medicine physician will bring you to a procedure suite, and you will be laying face up, on your back. 
  • Your skin will be cleaned using an antiseptic solution. 
  • Following this, under live x-ray, the bony landmarks corresponding to the location of the nerves will be identified. 
  • Local anesthetic will be injected in order to numb the skin. 
  • Following this, two specialized needles will be placed carefully for the hip cooled radiofrequency procedure, and three to four needles will be placed for the knee cooled radiofrequency procedure.  
  • Your physician will then test the needle placement. Sensory testing will be performed to ensure that you feel sensation only in the joint and not anywhere else on your leg. 
  • Following this, motor testing will be performed to ensure that you do not have motor stimulation to any muscles in your extremities. 
  • Next local anesthesia will be used to further anesthetize or numb the area.  
  • The probes then transmit radiowaves heating up to 60 degrees Celsius for 90-180 seconds, creating a lesion in the nerve. 
  • The needles will then be removed, and a sterile dressing applied.

Typically pain relief is felt shortly after the procedure, but it may take up to 4 weeks to have full benefit. 

Risks

Although extremely rare, risks may include bleeding; infection; allergic reaction to medication; damage to tendons, muscles and joints; and prolonged increase in pain. Rarely, one may experience a painful sensation in the skin above where the procedure was performed, which is typically short-lived and treated with a short course of oral medication. Your experienced pain management physician at the JLR Center for Pain Medicine will take all necessary precautions to try to prevent these complications.