Genicular nerve- conventional RF

[NJPAIN]

I have a Medicare patient that did very well with a genicular LA block. wanted to do a water-cooled RF of same but hospital says no. Are any of you using conventional thermal RF for these. If so:

What size probe?
How many lesions?

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[DOctorJay]

just some guy on youtube

 

[lobelsteve]

just some guy on youtube

Video is blocked, but that guy is probably a big idiot.

SML

 

[DOctorJay]

strange, it comes up in my browser and my iphone

here's the link if it's not working

 

[bedrock]

I have a Medicare patient that did very well with a genicular LA block. wanted to do a water-cooled RF of same but hospital says no. Are any of you using conventional thermal RF for these. If so:

What size probe?
How many lesions?

Cooled RF is unnecessary, but I'm thinking i may start using 16G cannulae when doing conventional RF for knees.

 

[Ligament]

It is a very small world we pain docs live in!

Great lecture Steve!

So happens I did a genicular RF case today with the 16 ga cannulae bedrock was discussing.

Strange because this procedure pays very little in the ASC setting and I got a case approved today basically on charity grounds. Normally I'm not allowed to do genicular RF at the ASC. I'd done this lady 2 years ago under ultrasound, but her knees are now too fat for me to use U/s so I needed flouro.

Doing it under U/s by the way is not fun.

 

[Taus]

I've been doing conventional with an 18g, 2 burns per nerve, moving second closer to condyle. My n is only 3, but seems more painful near/on periosteum than spine. Not sure if want to go 16g. I've been using a ton of local down to bone too. I've also been coming in w more ipsi lateral oblique to make sliding to mid shaft easier.

1 pt 20% relief, 1 90%, 1 complete medial, no better lateral knee pain.

For those who have done more: any differences in outcome noted for post tka vs just severe oa?