Dr. John Smirniotopoulos, an interventional radiologist at Georgetown/MedStar Washington Hospital Center, discusses the intricacies of genicular nerve ablation (GNA) for pain management in patients with osteoarthritis and post-surgical knee pain. He delves into the history and evolution of GNA, outlines the neurovascular anatomy, and explains his specific rationale for targeting various nerves for ablation.

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SYNPOSIS

Dr. Smirniotopoulos also compares GNA with other procedures such as corticosteroid injections, hyaluronic acid injections, and genicular artery embolization (GAE). He emphasizes the importance of managing patient expectations, the role of physical therapy, and explores different modalities of GNA, including the use of cryoablation versus radiofrequency technology. The episode offers a comprehensive overview of expert insights for evaluating knee pain and performing effective GNA.

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TIMESTAMPS

00:00 - Introduction

03:13 - Understanding Genicular Nerve Anatomy

12:06 - Tailoring GNA Treatment to Each Patient

22:39 - Comparing Ablation Devices and Methods

28:06 - GNA in Surgical and Post-Traumatic Patients

33:19 - Patient-Centered Decision Making

38:50 - Evaluating Functional Outcomes

43:39 - Comparing Treatment Modalities

49:34 - Post-Procedure Counseling and Expectations

58:40 - Future Directions in GNA Research

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RESOURCES

Safety and efficacy comparison of three- vs four-needle technique in the management of moderate to severe osteoarthritis of the knee using cooled radiofrequency ablation (Wong, et al 2021):

https://pubmed.ncbi.nlm.nih.gov/32968824/