There is a group of patients who does not want to go for knee replacement surgery or doesn’t physically fit for that surgery, still suffering from pain. For these group of patients have limited option of physiotherapy & painkiller medicine till now. But now recent advancement of technology there are different options available for knee pain. How ever all these treatment options works on different principles so selection of patient is very important for optimum results.Lets look for all these option one by one.
1) Genicular Artery Embolization
There is chronic inflammation is going on in osteoarthritis which leads to synovitis & cartilage degeneration. This chronic inflammation leads to neogenesis-> which leads to hypervascularity. This hypervascularity stimulate sensory nerves carrying pain signals & that’s why patients feels pain in knee joint . Genicular artery embolization targets such abnormal hypervascularity which leads to reduces inflammation & ultimately reduces pain.
Thorough evaluation of knee joint for abnormal hypervascularity in MRI & clinical examination is very important part for selection of patient for genicular artery embolization.
“coolief” is a new technology for treating osteoarthritis. Major complain of osteoarthritis is pain, if i remove pain than problem is solved. Coolief is advanced cooled radiofrequency nerve ablation technology. It works on the principle of heat generation & neurotomy.
There are 6 genicular nerve which supply knee joint. From this 3 nerves are responsible for pain in knee joint. If we treat this 3 point than pain can be reduced significantly. This entire procedure is done by needle, no cut-no suture -no bleeding at any site. Patient can resume her routine after few hours of rest.
Pre procedural genicular nerve block gives judgment about success of coolief. If more than 50% pain reduced in genicular nerve block than & than coolief should be performed.