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Radiofrequency Ablation

A procedure using heat generated by radio waves to disable nerves that transmit pain signals. Provides longer-lasting relief than nerve blocks for chronic joint pain. Also called RFA or radiofrequency neurotomy.

Extended Definition

Radiofrequency ablation (RFA) uses heat from radio waves to create a lesion on nerves that transmit pain signals. This “turns off” the nerve’s ability to send pain messages, providing relief that lasts months to over a year.

How It Works

  1. Diagnostic block first confirms which nerves cause pain
  2. Needle electrodes placed near target nerves (fluoroscopy-guided)
  3. Radio waves heat the nerve tissue to ~80°C
  4. Nerve disabled - can’t transmit pain signals
  5. Nerve regenerates over time (6-18 months)

Genicular RFA for Knee OA

For knee osteoarthritis, RFA targets the genicular nerves:

  • Superior medial genicular nerve
  • Superior lateral genicular nerve
  • Inferior medial genicular nerve

Candidacy:

  • Moderate to severe knee OA
  • Failed conservative treatments
  • Not ready or not candidate for surgery
  • Successful diagnostic nerve block

Results

Effectiveness:

  • 60-70% experience 50%+ pain reduction
  • Relief lasts 6-12 months on average
  • Can be repeated when pain returns

Advantages:

  • Outpatient procedure
  • Minimal recovery time
  • Preserves joint function
  • Can delay or avoid surgery

Procedure Details

  • Takes 30-60 minutes
  • Local anesthesia used
  • Mild sedation optional
  • Go home same day
  • Avoid strenuous activity for 24-48 hours

Insurance Coverage

Medicare covers RFA for knee OA when:

  • Documented failed conservative treatment
  • Successful diagnostic nerve block
  • Medical necessity established

Most private insurers also cover with prior authorization.

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