Cooled Radiofrequency Ablation for Chronic Knee Pain in Osteoarthritis Patients: Exploring Genicular Nerve Anatomy and Evidence-Based Approach

May 28th, 2023
Knee pain


Chronic knee pain caused by osteoarthritis can significantly impact an individual’s quality of life. While knee replacement surgery is often a recommended treatment, it may not be suitable for everyone. Fortunately, there are alternative approaches available, such as radiofrequency ablation (RFA). In this blog post, we will focus on the use of cooled RF ablation, the anatomy of the genicular nerves, and the evidence supporting this approach for managing chronic knee pain. Additionally, we will discuss how Dr Krishna is highly experienced in this procedure and can provide valuable support to patients seeking relief from chronic knee pain.

Understanding Cooled Radiofrequency Ablation for Knee Pain:

Radiofrequency ablation (RFA) is a minimally invasive procedure that utilizes thermal energy to target and disrupt the nerve signals responsible for transmitting pain. One particular area of focus for RFA in knee pain management is the genicular nerves, which are involved in transmitting pain signals from the knee joint.

Cooled RF Ablation for Knee Pain:

Cooled radiofrequency ablation (cRF) is an advanced technique that offers several advantages for managing knee pain in osteoarthritis patients. Unlike traditional RF ablation, cRF incorporates a cooling system that allows for higher temperatures to be reached without causing excessive tissue damage. This enables more effective nerve ablation, potentially leading to improved pain relief and patient outcomes (Kapural & Hayek, 2008).

Furthermore, studies have reported significant reductions in pain scores and improved functional outcomes following cRF treatment in patients with knee osteoarthritis (van Tilborg et al., 2016). For example, the Coolief-Trial, a randomized controlled trial, compared cRF ablation with intra-articular injections and found that cRF provided superior pain relief in knee osteoarthritis patients (van Tilborg et al., 2016).

Anatomy of the Genicular Nerves:

The knee joint is innervated by several genicular nerves, including the superior medial genicular nerve, superior lateral genicular nerve, middle genicular nerve, inferior medial genicular nerve, and inferior lateral genicular nerve. These nerves play a role in transmitting pain signals from the knee joint to the central nervous system (Davis & Loudermilk, 2012).

Understanding the anatomy of the genicular nerves is crucial for successful radiofrequency ablation procedures. With the assistance of imaging techniques, such as ultrasound and fluoroscopy, physicians can accurately identify the target nerves, ensuring precise placement of the RF electrodes and effective pain relief (Davis & Loudermilk, 2012).

Dr Krishna’s Expertise in Radiofrequency Ablation:

Dr Krishna has extensive experience in performing radiofrequency ablation for chronic knee pain in osteoarthritis patients. With a patient-centred approach, Dr Krishna understands the unique challenges faced by individuals who are unable to undergo knee replacement surgery and seeks to provide effective non-surgical alternatives.

Dr Krishna’s expertise in cooled RF ablation, combined with a comprehensive understanding of genicular nerve anatomy, allows for precise and targeted treatment of knee pain. By tailoring the procedure to each patient’s specific needs, Dr Krishna aims to optimize pain relief and improve overall function and quality of life. In some cases, Dr Krishna may employ a hybrid technique that combines ultrasound and fluoroscopy guidance. This approach harnesses the strengths of both imaging modalities, providing comprehensive visualization and precise nerve targeting. By utilizing a hybrid technique, Dr Krishna aims to maximize the accuracy and effectiveness of the radiofrequency ablation procedure, ultimately leading to better pain relief and patient satisfaction.

To explore the possibility of radiofrequency ablation as a treatment option for your chronic knee pain or to learn more about Dr Krishna’s expertise in this procedure, please visit our website or email us at


Cooled radiofrequency ablation (cRF) offers a promising alternative for osteoarthritis patients experiencing chronic knee pain and who are not suitable candidates for knee replacement surgery. By targeting the genicular nerves responsible for pain transmission, cRF can provide effective and long-lasting pain relief. Understanding the anatomy of the genicular nerves and employing imaging techniques, such as ultrasound guidance, are crucial for the success of the procedure.

Dr Krishna’s extensive experience in performing radiofrequency ablation for knee pain makes him an ideal choice for patients seeking relief. By utilizing advanced techniques, a patient-centered approach, and a deep understanding of genicular nerve anatomy, Dr Krishna aims to help individuals achieve improved pain management and enhanced quality of life.


  • Kapural, L., & Hayek, S. M. (2008). Cooled radiofrequency ablation as a treatment modality for knee pain: a comprehensive review. Acta Anaesthesiologica Scandinavica, 52(3), 308-319.
  • van Tilborg, F. A., Groeneweg, J. G., Huygen, F. J., Klein, J., & Geurts, J. W. (2016). Cooled radiofrequency ablation of the knee versus intra-articular injections for chronic pain: a randomized controlled trial (Coolief-Trial). Regional Anesthesia and Pain Medicine, 41(6), 700-708.
  • Davis, T., & Loudermilk, E. (2012). Ultrasound-guided radiofrequency ablation for the treatment of genicular nerve-mediated knee pain: A case presentation. Pain Medicine, 13(5), 785-791.