SIR 2024
Pain Management/MSK
Corliann Blyn, DO, MS
Transitional Year Intern
Inspira Health Network
Financial relationships: Full list of relationships is listed on the CME information page.
Alexander Sandberg, BS
Medical Student
Temple University / Lewis Katz School of Medicine
Disclosure information not submitted.
Joseph Panaro, MD
Clinical Associate Professor, Interventional Radiology
Temple University Hospital
Disclosure information not submitted.
Derek Lee, MD
Clinical Assistant Professor, Vascular and Interventional Radiology
Temple University Hospital
Disclosure information not submitted.
Dmitry Niman, MD
Clinical Professor, Radiology
Temple University Hospital
Disclosure information not submitted.
Gary Cohen, MD
Chair, Department of Radiology
Temple University Hospital
Disclosure information not submitted.
Perry Gerard, MD, FACR, MBA
Professor of Radiology
New York Medical College- Westchester Medical Center
Disclosure information not submitted.
Jared Meshekow, MD MPH
Clinical Assistant Professor, Vascular and Interventional Radiology
Temple University Hospital
Disclosure information not submitted.
1. To investigate geniculate nerve ablation as a viable adjunct or alternative to geniculate artery embolization.
2. To evaluate clinical findings and outcomes associated with geniculate nerve ablation.
3. To provide guidance on periprocedural workup and procedural steps for trainees and early career interventional radiologists.
4. To compare and contrast the potential advantages and limitations of geniculate nerve ablation versus embolization.
5. To emphasize the importance of patient selection and post-procedural care in optimizing outcomes.
Background:
Many people live with chronic knee pain, which significantly reduces their quality of life. Patients who have not responded to conservative management may benefit from minimally invasive treatment approaches. Despite evidence-based long-term benefits of geniculate artery embolization, patients with full-thickness cartilage defects and other non-inflammatory pathologies are less likely to benefit long-term. The presence of atherosclerosis or peripheral arterial disease may also preclude endovascular intervention. Geniculate nerve ablation may represent a promising alternative for these patients. This abstract provides a comprehensive guide tailored towards trainees and early career interventional radiologists on geniculate artery nerve ablation.
Clinical Findings/Procedure Details:
Geniculate nerve ablation entails the precise targeting of sensory nerves surrounding the knee joint resulting in the cessation of nociceptive pain signaling. The goal of this approach is to alleviate pain using thermal ablation techniques under image guidance. Considerations for geniculate nerve ablation include:
I. Review of Relevant Anatomy
II. Review of Procedural Techniques and Applicable Devices
III. Patient Selection and Periprocedural Workup
IV. Procedural Comparison of Geniculate Artery Embolization versus Nerve Ablation
V. Patient Follow-up and Management using a Multidisciplinary Patient-centric approach
Conclusion and/or Teaching Points:
Geniculate nerve ablation is a low-risk and well-tolerated minimally invasive approach for managing chronic knee pain. It may represent a viable alternative and or adjunct for patients who are unlikely to benefit from geniculate artery embolization. Trainees and early-career interventional radiologists who are involved in musculoskeletal intervention and pain management can benefit from a comprehensive understanding of geniculate nerve ablation.