What is joint denervation?

Joint denervation involves disabling the small nerves supplying the joint. This can be done with heat (radiofrequency ablation) or freezing (cryoablation). The purpose of the intervention is to reduce pain. The procedure does not affect the condition of the joint, meaning it does not cure wear and tear. However, the range of motion often improves somewhat because with the decrease in pain and the cessation of sudden sharp pain, healthy muscles can function better.

In which diseases/conditions is joint denervation used?

This procedure has been developed for advanced degenerative conditions of the knee (knee arthrosis), shoulder (shoulder arthrosis), and hip (hip arthrosis) for patients who do not want or cannot receive a prosthesis due to other diseases. Patients who already have a prosthesis but still have significant pain may also benefit from this procedure.

When is the procedure not recommended?

  • The procedure is contraindicated in cases of local infection.
  • Also, if the diagnostic block does not provide at least 50% pain relief for at least a few hours.

How is joint denervation performed?

The procedure is ultrasound-guided and takes place in the office. It takes about 45 minutes, after which the patient can go home with a companion after about 30 minutes of rest.

Usually, the procedure is performed under sedation, so the patient does not perceive the procedure. The doctor numbs the skin, then inserts the needle into the appropriate area and administers the medications.

What happens after the procedure?

After the procedure, the pain may intensify for a few days, and it may take up to 7 days for the full effect to develop.

Taking additional pain relievers after the procedure is typically not necessary.

Normal activities can be resumed the day after the procedure.

What can the patient do for recovery?

Physical therapy is almost mandatory for all musculoskeletal conditions, including knee, hip, and shoulder osteoarthritis.

Adding PRP treatment to promote the long-term biomechanical integrity of the joint and improve cartilage function and condition.

Pre-procedure instructions

Kumurin, marfarin, plavix, heparin, fragmin, and other anticoagulants increase the risk of bleeding.

If you are taking these or similar medications, it is important to inform your treating physician during the planning phase of the procedure. You should not stop taking these medications on your own.

How should the patient prepare for the procedure?

For patients

Possible complications of joint denervation

Like any procedure, denervation has its risks, but these interventions typically carry a low risk and do not significantly burden the patient’s body.

Possible complications include:

  • Pain at the injection site
  • Inflammation
  • Infection (abscess)
  • Bleeding
  • Nerve damage
  • Allergic reaction
  • Hematoma

If any of the above complications occur, you should contact us within 24 hours. In urgent cases, you should report to the nearest emergency department.

References:

1. Choi WJ, Hwang SJ, Song JG, Leem JG, Kang YU, Park PH, et al. Radiofrequency treatment relieves chronic knee osteoarthritis pain: A double-blind randomized controlled trial. Pain [Internet]. 2011;152(3):481–7. Available from: http://dx.doi.org/10.1016/j.pain.2010.09.029

2. Ajrawat P, Radomski L, Bhatia A, Peng P, Nath N, Gandhi R. Radiofrequency Procedures for the Treatment of Symptomatic Knee Osteoarthritis: A Systematic Review. Pain Med. 2019;1–16.