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Genicular nerve

María M Santana Pineda, Luc E Vanlinthout, Ana Moreno Martín, Jan van Zundert, Fernando Rodriguez Huertas, José P Novalbos Ruiz
BACKGROUND AND OBJECTIVES: Radiofrequency ablation of genicular nerves has proved to be successful in relieving pain and incapacity caused by osteoarthritis of the knee. However, long-term efficacy of such a treatment remains to be assessed. The current study aimed to reproduce radiofrequency neurotomy of genicular nerves to manage gonarthrosis pain and disability and establish therapeutic response until 1 year after intervention. METHODS: This single-center, prospective, observational, noncontrolled, longitudinal study included patients with grade 3 to 4 gonarthrosis suffering from intractable knee pain, scoring 5 or more on the visual analog scale (VAS) during >6 months...
November 22, 2016: Regional Anesthesia and Pain Medicine
Joshua Wong, Nicholas Bremer, Paul D Weyker, Christopher A J Webb
Osteoarthritis (OA) of the knee is one of the most common joint diseases affecting adults in the United States. For elderly patients with multiple medical comorbidities who do not wish to undergo total knee arthroplasty (TKA), lifestyle modification, pharmacologic management, and injections are the mainstay of therapy. Previously, pain management interventions were limited to intra-articular joint injections and viscosupplementation with hyaluronic acid. Fluoroscopic-guided techniques for radiofrequency ablation (RFA) of the genicular nerves have been previously described and a recent cadaveric study suggests that ultrasound-guided genicular nerve blocks can be performed accurately...
2016: Case Reports in Anesthesiology
Norachart Sirisreetreerux, Babar Shafiq, Greg M Osgood, Erik A Hasenboehler
OBJECTIVES: To determine the location of distal medial neurovascular structures, identifying a medial "safe zone" for minimally invasive plate osteosynthesis to treat displaced femoral condylar fractures. METHODS: Eleven uninjured lower-half torsos were dissected on the bilateral medial lower thigh. A longitudinal incision was made at the midsagittal plane of the medial thigh starting 1 cm proximal to the knee joint and extending to the proximal one-third of the femur...
November 2016: Journal of Orthopaedic Trauma
David Schanbacher, Michelle Poliak-Tunis, Michael J Suer
No abstract text is available yet for this article.
September 2016: PM & R: the Journal of Injury, Function, and Rehabilitation
Salima Qudsi-Sinclair, Enrique Borrás-Rubio, Juan F Abellan-Guillén, María Luz Padilla Del Rey, Guadalupe Ruiz-Merino
BACKGROUND: Knee osteoarthritis is a disease that affects a third of the population over 65 years of age, and it is increasingly becoming a motive for consultation and a source of pain and disability. The gold standard surgical treatment is a total knee arthroplasty; however, 15% to 30% of patients who have undergone surgery continue to experience pain and functional limitation. METHODS: A double-blind, randomized clinical study compared neurolysis using traditional radiofrequency (RF) to local anesthetic and corticosteroid block of the superolateral, superomedial, and inferomedial branches of the knee genicular nerves in patients who had total knee arthroplasty but still experience pain...
September 19, 2016: Pain Practice: the Official Journal of World Institute of Pain
Michael E Farrell, Genaro Gutierrez, Mehul J Desai
: This case presentation demonstrates radiographic evidence of lesions created following cooled radiofrequency (cRF) neurotomy of the knee. A 67-year-old man presented with chronic left knee osteoarthritis, pain, and disability. After a failed trial of conservative treatments, the patient underwent diagnostic genicular nerve blocks and subsequent cRF neurotomy, of the left knee. Shortly after cRF, magnetic resonance imaging (MRI) of the left knee was performed. On MRI, lesions created by cRF ablation were identified...
September 14, 2016: PM & R: the Journal of Injury, Function, and Rehabilitation
Sinem Sarı, Osman N Aydın, Yasemin Turan, Pınar Özlülerden, Ufuk Efe, İmran Kurt Ömürlü
OBJECTIVES: To compare the efficacy of intra-articular injection and radiofrequency (RF) neurotomy of genicular nerves in patients with chronic knee osteoarthritis (OA) pain. METHODS: Seventy-three patients with knee OA were included in the study. Patients were randomly assigned to Group IA (intra-articular 2.5 mL of bupivacaine, 2.5 mg of morphine and 1 mL of betamethasone, 6 mL of fluid injection) or Group RF (RF neurotomy of the genicular nerves). The outcome measures included a pain scale (visual analog scale, VAS) and Western Ontario and McMaster Universities (WOMAC) Index of Osteoarthritis...
August 12, 2016: International Journal of Rheumatic Diseases
Norachart Sirisreetreerux, Babar Shafiq, Greg M Osgood, Erik A Hasenboehler
OBJECTIVES: To determine the location of distal medial neurovascular structures, identifying a medial "safe zone" for minimally invasive plate osteosynthesis to treat displaced femoral condylar fractures. METHODS: Eleven uninjured lower-half torsos were dissected on the bilateral medial lower thigh. A longitudinal incision was made at the midsagittal plane of the medial thigh starting 1 cm proximal to the knee joint and extending to the proximal one-third of the femur...
July 21, 2016: Journal of Orthopaedic Trauma
Serdar Kesikburun, Evren Yaşar, Ayça Uran, Emre Adigüzel, Bilge Yilmaz
BACKGROUND: Genicular nerve ablation with radiofrequency (RF) has recently emerged as a promising treatment in the management of osteoarthritis related knee pain. To date, genicular nerve injections have been performed under fluoroscopic guidance. OBJECTIVE: To evaluate the effect of ultrasound-guided genicular nerve pulsed RF treatment on chronic knee pain and function in patients with knee osteoarthritis. STUDY DESIGN: Single-arm prospective study...
July 2016: Pain Physician
Soo Yeon Kim, Phuong Uyen Le, Boleslav Kosharskyy, Alan D Kaye, Naum Shaparin, Sherry A Downie
Genicular nerve radiofrequency ablation (RFA) has recently gained popularity as an intervention for chronic knee pain in patients who have failed other conservative or surgical treatments. Long-term efficacy and adverse events are still largely unknown. Under fluoroscopic guidance, thermal RFA targets the lateral superior, medial superior, and medial inferior genicular nerves, which run in close proximity to the genicular arteries that play a crucial role in supplying the distal femur, knee joint, meniscus, and patella...
July 2016: Pain Physician
Rakhi G Sutaria, Se Won Lee, Soo Yeon Kim, Ruth Howe, Sherry A Downie
BACKGROUND: The lateral retinacular nerve (LRN) is a branch of the superior lateral genicular nerve (SLGN) and is believed to contribute to anterolateral knee pain. The precise anatomical pathway of the LRN, however, has not been demonstrated as it relates to the performance of targeted nerve block procedures. OBJECTIVE: To describe the anatomical landmarks for localization of the LRN to facilitate diagnostic and therapeutic nerve blocks in the treatment of chronic anterolateral knee pain...
June 23, 2016: PM & R: the Journal of Injury, Function, and Rehabilitation
Sinem Sarı, Osman Nuri Aydın, Yasemin Turan, Selda Şen, Pınar Özlülerden, İmran Kurt Ömürlü, Ferdi Gulastı
This study aimed to perform genicular nerve RF neurotomy using two different imaging methods, fluoroscopy and ultrasound, and to compare the clinical effects and reliability of the two methods. Fifty patients with osteoarthritis were included in this study. Patients were randomly allocated into group 1 (fluoroscopy imaging) and group 2 (ultrasound imaging). Outcomes were measured using a pain scale (visual analog scale; VAS) and the Western Ontario and McMaster Universities (WOMAC) Index of Osteoarthritis. The application time in the ultrasound group (20...
May 3, 2016: Journal of Clinical Monitoring and Computing
David Burckett-St Laurant, Philip Peng, Laura Girón Arango, Ahtsham U Niazi, Vincent W S Chan, Anne Agur, Anahi Perlas
BACKGROUND AND OBJECTIVES: Adductor canal block contributes to analgesia after total knee arthroplasty. However, controversy exists regarding the target nerves and the ideal site of local anesthetic administration. The aim of this cadaveric study was to identify the trajectory of all nerves that course in the adductor canal from their origin to their termination and describe their relative contributions to the innervation of the knee joint. METHODS: After research ethics board approval, 20 cadaveric lower limbs were examined using standard dissection technique...
May 2016: Regional Anesthesia and Pain Medicine
Emre Adiguzel, Ayça Uran, Serdar Kesikburun, Özlem Köroğlu, Yasin Demir, Evren Yaşar
BACKGROUND: Heterotopic ossification (HO) is the ectopic bone formation in non-osseous tissues. This study aimed to present two patients with traumatic brain injury (TBI) who had HO in knee joint and pain relief after genicular nerve blockage. Case 1: A 14-year-old patient with TBI was admitted with bilateral knee pain and limited range of motion. Physical examination and x-ray graphics revealed calcification which was diagnosed as HO. Ultrasonography (US) guided genicular nerve blockage was performed to both knees with 2 ml lidocaine and 1 ml betamethasone...
2015: Brain Injury: [BI]
Evren Yasar, Serdar Kesikburun, Cenk Kılıç, Ümüt Güzelküçük, Fatih Yazar, Arif Kenan Tan
BACKGROUND: Genicular nerve block has recently emerged as a novel alternative treatment in chronic knee pain. The needle placement for genicular nerve injection is made under fluoroscopic guidance with reference to bony landmarks. OBJECTIVE: To investigate the anatomic landmarks for medial genicular nerve branches and to determine the accuracy of ultrasound-guided genicular nerve block in a cadaveric model. STUDY DESIGN: Cadaveric accuracy study...
September 2015: Pain Physician
Martina Bellini, Massimo Barbieri
BACKGROUND: Knee osteoarthritis is a frequent cause of chronic knee pain. Therapeutic solutions include intra-articular injections with short-term pain relief and surgical therapy. Radiofrequency (RF) of genicular nerves has been previously reported with varying success. Cooling tissue adjacent to the electrode (cooled RF) increases the radius of lesion. We present here the first retrospective data on pain relief and changes in function after such cooled RF denervation. METHODS: We reviewed the records of nine patients with chronic knee pain who underwent cooled RF of genicular nerves...
2015: Anaesthesiology Intensive Therapy
Stephen J Head, Rochelle C Leung, Greg P T Hackman, Rachael Seib, Kevin Rondi, Stephan K W Schwarz
PURPOSE: Reliable saphenous nerve blockade is a desirable complement to popliteal sciatic nerve blockade for foot and ankle surgery. We compared two promising ultrasound-guided techniques, the supine adductor canal (AC) technique and the prone peri-saphenous branch of the descending genicular artery (Peri-SBDGA) technique, using 8 mL of 2% lidocaine with epinephrine 1:400,000. METHODS: Following Research Ethics Board approval, we conducted a randomized single-blinded parallel-group trial in 102 patients undergoing foot and ankle surgery at a single centre...
January 2015: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
Nicole M Protzman, Jennifer Gyi, Amit D Malhotra, Jason E Kooch
Recently, investigators began using radiofrequency to manage knee osteoarthritis pain in patients at high risk who cannot undergo surgical intervention. To our knowledge, no study has investigated the use of radiofrequency ablation of the genicular nerves to alleviate chronic knee pain after total knee replacement. A single case is presented here in which genicular nerve ablation successfully improved pain and restored function. We believe that these preliminary results could be used in the development of future prospective cohort studies and randomized controlled trials that focus on the use of radiofrequency ablation to treat persistent knee pain after total knee replacement...
April 2014: PM & R: the Journal of Injury, Function, and Rehabilitation
Robert J Spinner, Nicholas M Desy, Gautum Agarwal, Wojciech Pawlina, Manju Kalra, Kimberly K Amrami
Cystic adventitial disease (CAD) is a rare condition in which cyst is found within a vessel, typically producing symptoms of vascular compromise. Most commonly located in the popliteal artery near the knee, it has been reported in arteries and veins throughout the body. Its pathogenesis has been poorly understood and various surgical approaches have been recommended. We extrapolated some recent information about a similar condition, intraneural ganglion cyst affecting the deep fibular (peroneal) nerve, to the prototype, CAD of the popliteal artery...
March 2013: Clinical Anatomy
J Visser, J-M Brinkman, R L A W Bleys, R M Castelein, R J van Heerwaarden
PURPOSE: To investigate the feasibility and safety of a less invasive surgical approach to the distal medial aspect of the femur in supracondylar medial closing wedge osteotomy for the treatment of lateral compartment osteoarthritis of the knee. The aim of a less invasive approach is to minimize soft tissue disruption, reduce damage to neurovascular structures and thereby prevent muscle atrophy and optimize bone healing potential. METHODS: A human cadaver dissection study on the vascular and neural structures of the medial side of the distal femur was conducted...
January 2013: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
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