MIPSI or Minimally invasive pain and spine interventions is a broad term which encompasses all the Non-invasive and minimally invasive interventions done by the interventional spine and pain physicians for myriad of conditions right from Musculo-skeletal disorders like back pain, neck pain, knee pain etc.
What is the procedure of Knee joint Radiofrequency neurectomy?
Knee joints are supplied by articular branches called as Genicular nerves. There are 4 genicular nerves around the knee joint
- Superomedial genicular nerve
- Superolateral genicular nerve
- Inferomedial genicular nerve
- Inferolateral genicular nerve
Knee joint Radiofrequency neurectomy is an advanced procedure which involves a precise identification of these articular branches( nerves supplying only the joint ) with the help of sensory and motor stimulation and then targeted ablation of these nerves using Radiofrequency current. Extreme caution is taken to spare the main sensory and motor nerves and only target the articular branches supplying the joint. Inferolateral genicular nerve is spared in this procedure because of its proximity to Common peroneal nerve whose inadvertent lesion can cause foot drop in the patients.
What are the Indications of Knee joint neurectomy?
- Knee joint Osteo-arthritis
- Post TKR pain
- Patient medically unfit for Knee replacement
- Chronic Knee pain
- Auto-immune conditions like Rheumatoid arthritis
How Knee joint neurectomy MIPSI helps relief pain?
Knee joint Radiofrequency neurectomy specifically targets the articular branches of the nerves supplying the joint.
It mainly acts by 2 mechanisms:
Peripheral Wallerian degeneration of the nerve: Due to the application of Radiofrequency currents , the friction between the various tissue molecules generate thermal energy which burns the nerves and brings about what is called as conduction block. So these nerves stop conducting pain signals from the affected site towards the brain where pain stimulus is actually processed and patient feels immediate relief from pain.
Central neuromodulation: Chronic pain has a component of Central Sensitization where in there is amplification of the pain signals in the brain and patients experience pain even in the absence of any movements or painful stimulus. With application of Radiofrequency ablation there is modulation in these central neural circuitries and the central sensitization is abolished.
How early the beneficial effects can be seen?
Patient can start appreciating the effect of the procedure within 3-4 days post-procedure and maximal effect is achieved over a period of 3-4 weeks.
How many times this procedure has to be repeated?
Radiofrequency ablation procedure may need to be repeated after 8-12 months which is the time required for regeneration of ablated nerves. However, when combined with good rehabilitation post-procedure, beneficial effects of radiofrequency ablation can extend upto 1.5 -2 years. Decision to repeat the procedure is taken by your doctor looking at your reports and the relief percentage from previous procedure.
Will I require hospitalization for this procedure?
No. This is a Day care procedure. Patient is advised about the Pre-procedure precautions before- hand. On the day of the procedure, patient arrives 2 hours before the procedure and is discharged same day after 2 hours of monitoring
To see how this procedure is done, click the below link