We have located links that may give you full text access.
Journal Article
Review
Is Genicular Nerve Radiofrequency Ablation Safe? A Literature Review and Anatomical Study.
Pain Physician 2016 July
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. Long-term efficacy and adverse events are still largely unknown. Under fluoroscopic guidance, thermal RFA targets the lateral superior, medial superior, and medial inferior genicular nerves, which run in close proximity to the genicular arteries that play a crucial role in supplying the distal femur, knee joint, meniscus, and patella. RFA targets nerves by relying on bony landmarks, but fails to provide visualization of vascular structures. Although vascular injuries after genicular nerve RFA have not been reported, genicular vascular complications are well documented in the surgical literature. This article describes the anatomy, including detailed cadaveric dissections and schematic drawings, of the genicular neurovascular bundle. The present investigation also included a comprehensive literature review of genicular vascular injuries involving those arteries which lie near the targets of genicular nerve RFA. These adverse vascular events are documented in the literature as case reports. Of the 27 cases analyzed, 25.9% (7/27) involved the lateral superior genicular artery, 40.7% (11/27) involved the medial superior genicular artery, and 33.3% (9/27) involved the medial inferior genicular artery. Most often, these vascular injuries result in the formation of pseudoaneurysm, arteriovenous fistula (AVF), hemarthrosis, and/or osteonecrosis of the patella. Although rare, these complications carry significant morbidities. Based on the detailed dissections and review of the literature, our investigation suggests that vascular injury is a possible risk of genicular RFA. Lastly, recommendations are offered to minimize potential iatrogenic complications.
Full text links
Related Resources
Trending Papers
Challenges in Septic Shock: From New Hemodynamics to Blood Purification Therapies.Journal of Personalized Medicine 2024 Februrary 4
Molecular Targets of Novel Therapeutics for Diabetic Kidney Disease: A New Era of Nephroprotection.International Journal of Molecular Sciences 2024 April 4
The 'Ten Commandments' for the 2023 European Society of Cardiology guidelines for the management of endocarditis.European Heart Journal 2024 April 18
A Guide to the Use of Vasopressors and Inotropes for Patients in Shock.Journal of Intensive Care Medicine 2024 April 14
Diagnosis and Management of Cardiac Sarcoidosis: A Scientific Statement From the American Heart Association.Circulation 2024 April 19
Essential thrombocythaemia: A contemporary approach with new drugs on the horizon.British Journal of Haematology 2024 April 9
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app
All material on this website is protected by copyright, Copyright © 1994-2024 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.
By using this service, you agree to our terms of use and privacy policy.
Your Privacy Choices
You can now claim free CME credits for this literature searchClaim now
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app