Chronic knee pain can be debilitating, limiting mobility, reducing quality of life, and interfering with everyday activities. Conditions like osteoarthritis cause the cartilage in the knee joint to break down, leading to persistent discomfort that does not always respond to medications, physical therapy, or injections. For many patients seeking alternatives to surgery, genicular nerve ablation has become a promising option that offers meaningful relief without the risks and recovery time of major joint replacement surgery.

Understanding Genicular Nerves

The knee joint is surrounded by a network of sensory nerves known as genicular nerves. These nerves carry pain signals from the knee joint to the brain, particularly in the setting of chronic conditions like osteoarthritis or degenerative joint disease. When these nerve pathways are disrupted, the transmission of pain signals is reduced, often resulting in significant relief for the patient.

What Is Genicular Nerve Ablation?

Genicular nerve ablation is a minimally invasive outpatient procedure in which targeted genicular nerves are treated with radiofrequency energy to impair their ability to send pain signals. Essentially, the physician uses imaging guidance — such as fluoroscopy or ultrasound — to place small needles near the pain‑sensing nerves around the knee. A radiofrequency probe is then passed through the needles, delivering controlled heat to the nerve tissue. This heat disrupts the nerve fibers responsible for transmitting pain.

Unlike traditional surgery, genicular nerve ablation does not involve cutting, replacing, or implanting artificial components in the knee. The whole process typically takes less than an hour, and most patients go home the same day. Pain relief often begins within a few weeks of the procedure and can last six months to a year or even longer for some individuals.

Who Is A Candidate For The Procedure?

Genicular nerve ablation is usually considered for patients who:

• Suffer from chronic knee pain, especially due to knee osteoarthritis.

• Have not experienced sufficient relief from conservative treatments like NSAIDs, physical therapy, or corticosteroid injections.

• Are not ideal candidates for knee replacement surgery due to age, medical conditions, or personal preference.

• Wish to delay or avoid knee surgery altogether.

Before the ablation itself, a diagnostic genicular nerve block (a temporary numbing injection) is often performed. If the block significantly reduces pain, it suggests that the ablation is likely to be effective.

The Procedure: Step‑By‑Step

1. Preparation: The skin around the knee is cleaned and a local anesthetic is administered. Mild sedation may also be used in some cases.

2. Imaging Guidance: Using fluoroscopy (live X‑ray imaging) or ultrasound, the physician places needles near the targeted genicular nerves.

3. Radiofrequency Ablation: A thin electrode is inserted through each needle and activated. The electrode generates heat that disables the nerve’s pain–transmitting ability.

4. Completion: After treating three key genicular nerves, the procedure is complete. The knee is bandaged before the patient goes home.

Benefits Of Genicular Nerve Ablation

The most significant advantages of genicular nerve ablation include:

• Long‑Lasting Pain Relief: Many patients report significant pain reduction that lasts for months.

• Minimally Invasive: There’s no need for large incisions, general anesthesia, or long hospital stays.

• Quicker Recovery: Patients can usually resume normal daily activities within a short period after the procedure.

• Reduced Need for Medications: Relief from pain often allows patients to rely less on NSAIDs or opioids.

• Alternative To Surgery: For patients unwilling or unable to undergo knee joint replacement, this procedure offers a safe and effective option.

What Does The Evidence Say?

Recent research supports the effectiveness and safety of genicular nerve ablation. A systematic review and meta‑analysis found that ablation techniques (especially radiofrequency) significantly reduced knee pain and improved function compared with sham procedures, with no serious adverse events reported. These findings suggest that, for carefully selected patients, genicular nerve ablation offers a clinically meaningful improvement in pain and quality of life.

Potential Risks And Considerations

Like any medical procedure, genicular nerve ablation carries some risks — though they are uncommon. Possible complications may include:

• Temporary discomfort or soreness at the injection sites.

• Infection or bleeding, which is rare but possible.

• Numbness, weakness, or irritation near the treated nerves.

• Allergic reaction to local anesthetics in very rare cases.

Discussing your health history and expectations with your physician is essential to determine if ablation is right for you.

Final Thoughts

Chronic knee pain doesn’t have to define your life. For many patients, genicular nerve ablation provides a minimally invasive, effective alternative to surgery, offering months of reduced pain, improved mobility, and greater independence. If you’ve struggled with knee pain despite conservative therapies, talk to your healthcare provider about whether this innovative procedure might help you achieve long‑lasting relief.