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. These branches around the knee joint are known as genicular nerves.
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In all specimens the superolateral quadrant was innervated by the nerve to vastus lateralis nerve to vastus intermedius superior lateral genicular and common fibular nerves.
Genicular nerves anatomy. Several genicular nerves can be easily approached with a needle under fluoroscopic guidance. Genicular nerve ablation this is the therapeutic portion of the treatment whereby the physician will perform a radiofrequency ablation rfa of the genicular nerves thus alleviating pain to the knee and restoring function. Patients can get a diagnostic genicular nerve block to determine if this will provide adequate relief.
Cadaveric dissections detailing the. Inferolateral by the inferior lateral genicular and recurrent fibular nerves. All of these different types of anatomy are crisscrossed and enervated by a network of femoral common peroneal saphenous tibial and obturator nerves.
Tributaries from tibial common peroneal femoral and obturator nerves are found around the knee proper 34. These nerves are broadly known as genicular nerves. Geniculate nerve anatomy the nerve network supplying the knee joint is complex.
1 these genicular nerves are increasingly being targeted for radiofrequency ablation to alleviate the pain of patients not adequately treated by other treatments. The nerves of significance to rfa of the knee include the branches of the common perone al and tibial nerves. Then ascends anterior to the knee joint together with the anterior recurrent tibial artery to supply the knee joint and the tibialis anterior muscle.
Both portions of the procedure are performed as an outpatient under direct fluoroscopic guidance. And inferomedial by the inferior medial genicular nerve. The targets included the sl sm and im genicular nerves which pass periosteal areas connecting the shaft of the femur to bilateral epicondyles and the shaft of the tibia to the medial epicondyle.
The geniculate ganglion contains special sensory neuronal cell bodies for taste from fibers coming up from the tongue through the chorda tympani and from fibers coming up from the roof of the palate through the greater petrosal nerve. Superomedial by the nerve to vastus medialis nerve to vastus intermedius and superior medial genicular nerve. Sensory and parasympathetic inputs are carried into the geniculate ganglion via.
A genicular nerve block is a procedure where these nerves are anesthetized blocked with local anesthetic injected through small needles. Each type of nerve is the relay for pain signals that originate in a different area of your knee. Recurrent genicular nerve it arises from the point of division of the common fibular nerve.
Genicular nerves consist of the superior lateral sl middle superior medial sm inferior lateral il inferior medial im and recurrent tibial genicular nerve. Long term efficacy and adverse events are still largely unknown. Genicular radiofrequency ablation benefits peripheral nerves innervating the knee include several branches of the genicular nerve.
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