Knee and Hip Pain

Knee and Hip

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    Audrey Stevenson
    Audrey Stevenson

    Client Testimonial

    "My walking ability has increased from 10 minutes to 45 minutes, without pain. My next goal is the stairs."

      Martin Hoyne
      Martin Hoyne

      Client Testimonial

      "Soreness is now an anomaly. I'm 95% pain free."

        Retired NHL Goalie
        Retired NHL Goalie

        Retired NHL Goalie

        "I was running at 30%, now I'm at 95%. I feel like I have new knees"

          Laura Ferguson
          Laura Ferguson

          Client Testimonial

          "The change is remarkable. At least 80% better."

            Stacy Chan
            Stacy Chan

            Client Testimonial

            "It's my own body healing itself, and thats what I like about it."

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            Doctor checking patient with knees to determine the cause of illness

            Radiofrequency Ablation

            Knee Radiofrequency Ablation (RFA) is a minimally invasive treatment for patients suffering from chronic knee pain secondary to osteoarthritis. This procedure is intended to provide significant long term pain relief.

            Knee RFA procedure can help delay or even avoid knee surgery and can also provide pain relief to patients who already have had knee replacement surgery.

            What are some of the indications for Knee Radiofrequency Ablation – who should have this treatment?

            -Patients with Chronic Knee Pain Secondary to osteoarthritis
            -Patients who have undergone knee replacement with persistent knee pain
            -Patients unfit for Knee replacement (medical comorbidities, morbid obesity)
            -Patients who want to avoid surgery

            What is involved with the procedure itself? How does it work?

            Knee radiofrequency ablation is an outpatient procedure where under image guidance (Xray and/or Ultrasound) a specialized needle is used to heat the nerve supply (genicular nerves) to the knee. After the heat is applied in this way the nerve supply is unable to continue sending pain signal to the brain.

            Before an RFA is completed, it may or may not be recommended to have a Diagnostic Genicular Nerve Block completed, in order to ensure the procedure will be of benefit (i.e. to confirm the nerve root responsible for the pain signal).

            What is a Diagnostic Genicular Nerve Block?

            This a diagnostic procedure where the nerve supply to the knee is frozen with local anesthetic. If there is significant temporary reduction of knee pain, then a patient is considered a candidate for the knee RFA procedure.

            Under image guidance a small amount of local anesthetic (1.5 ml) of lidocaine is injected around the 3 main nerve that supply the knee joint (the superior latera, superior medial and inferior medial genicular branches). A response is considered if there is at least 50% reduction in pain following the procedure.

            This is done on a different day than the procedure itself, but if there is a significant reduction in pain post procedure, the Radio Frequency Ablation can be booked within the following week.

            What are the potential associated risks of a Radio Frequency Knee Ablation?

            Complications are very rare, especially if done using precise image guidance technique and using strict aseptic technique. Some rare, but reported adverse events include:

            -Skin burns
            -Temporary knee swelling
            -Post procedural pain (periosteum (bone) touch pain, temporary knee swelling, skin burns)
            -Hemarthrosis, hematoma
            -Subcutaneous bleeding at the needle insertion site.
            -Hypoesthesia (patchy numbness) of the overlying skin.

            Who is not a candidate?

            -Anyone with a local infection, or blood infection
            -Any patient with a pacemaker may or may not be considered a candidate

            What is the downtime after the procedure?

            Although this will vary for each individual based on their baseline activity level, high intensity weight bearing activities should be avoided, but normal activity as tolerated can be resumed the following day, with pain being the limiting factor. If you are experiencing discomfort post procedure, do not push the intensity.

            Post procedure discomfort is minimal, Tylenol or other over the counter anti-inflammatory analgesics may be taken orally to manage related discomfort.

            What the recommended rehabilitation post procedure?

            Rehabilitation is highly encouraged, to strengthen surrounding structures that may have atrophied as a result of limited activity related to pain. Our allied health team of specialized physiotherapy and kinesiology can discuss a tailored plan to collaborate on your return to exercise, lifestyle or other performance activities.