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No, but this is the only procedure that I find easier to perform on really obese patients.
Genicular nerve RFA
- Thread starter Extralong
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No, but this is the only procedure that I find easier to perform on really obese patients.
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Weird...how did blood get into the joint? Its an extra-articular injection...
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It is weird, but it makes some sense. Suprapatellar pouch lays right over area of superomedial and lateral genicular nerves. We all go through that pouch if our patients have nasty knees with effusions. I use thick RF needles so that probably helped too...
More cushion for the pushin
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just had a large, very normal lady come in for follow up. KL3 knee OA bilateral. performed left knee genicular blocks 3 weeks ago. previously, i had tried HA, and even 1x 40x kenalog + local anesthetic. both were mediocre, and lasted less than 4 weeks.
she is now 3 weeks post genicular blocks. states that her left knee pain is 1 out of 10 on VAS. right knee 8/10. she does not take any medications for pain - "not interested" she is very happy with the outcomes from this procedure. "whatever you did, it's better than those other injections before"
Just wanted to share the experience. find it interesting when these very normal, non supra-tentorial patients come back and report significant pain relief from the genicular blocks that greatly outlast the expected duration of medication effect. I let everyone know that these are diagnostic blocks and are meant to be evaluated for benefit the day of procedure.
she is now 3 weeks post genicular blocks. states that her left knee pain is 1 out of 10 on VAS. right knee 8/10. she does not take any medications for pain - "not interested" she is very happy with the outcomes from this procedure. "whatever you did, it's better than those other injections before"
Just wanted to share the experience. find it interesting when these very normal, non supra-tentorial patients come back and report significant pain relief from the genicular blocks that greatly outlast the expected duration of medication effect. I let everyone know that these are diagnostic blocks and are meant to be evaluated for benefit the day of procedure.
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Have had the same
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Yes, Tim Davis study
Not viable from cost prospective. Perhaps in an asc.
When you visualize the actual nerve under US the outcomes suddenly improve
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Do u do combined flouro and US?
Can u post US pics?
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Sounds like great idea, but cost again plays a role as US isn't reimbursed anymore.
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Do you have concerns of full thermal RF (80 degrees for 90 seconds) for patients with hardware? Where do you put the grounding pad?
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Never had a problem. Unsure what kind of risk you think can exist.
Pad goes on thigh
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i dunno, a thermal burn from the metal conducting the heat in case the needle tip is touch it. might sound stupid, sorry. also pad on same side thigh?
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I think impedance readings will make machine fail. I can try today outside body.
Same thigh
Same thigh
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yea good point. thats true. let me know how it goes!
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How did you treat this may I ask. Compression bandage, or did you hold anticoagulant and aspirate hemearthrosis?
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how'd it go!
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Too busy to set it up.
Might get things going next week and shoot video.
Might get things going next week and shoot video.
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You could definitely get a more intense burn around the contact site. If you are dealing with a partially insulated metal device, you could get a burn at the other side of the device, or at the other end of a lead, for example.
I would expect the machine to "work" because the actual circuit, with or without a metal conduit within it, is going to be identical as far as the machine knows. Testing this outside the body may not be accurate and could trigger an error because of a short circuit.
It doesn't matter where the grounding pad is as long as it makes full contact with skin over muscle/fat. Just keep in mind the current is running from your probe, though the body, to the grounding pad. So you want to avoid sensitive detection circuits (pacer/defibrillator) in the line of your current.
This is regarding nerve conduction studies and pacers but similar principle:
Practice FAQs | American Association of Neuromuscular & Electrodiagnostic Medicine Six
