Genicular Nerve Cooled Radiofrequency Ablation (Cooled RFA)
If chronic knee pain is limiting your movement and conventional treatments are no longer delivering adequate relief, Genicular Nerve Cooled Radiofrequency Ablation (Cooled RFA) is an advanced non-surgical treatment that provides long-lasting pain relief — with a broader treatment zone than standard RFA, and a recovery time measured in days rather than months.
What Is Genicular Nerve Cooled RFA?
Standard radiofrequency ablation generates heat concentrated at the tip of the needle, producing a relatively small, elongated lesion. Cooled RFA incorporates an internal water-cooling system within the probe, which actively manages tip temperature. This prevents overheating at the tip and allows significantly more radiofrequency energy to be delivered safely into the surrounding tissue — creating a larger, more spherical treatment zone that covers the genicular nerves more completely.
At the knee, the genicular nerve anatomy varies between individuals, making complete nerve coverage with a small treatment zone unreliable. Cooled RFA's broader ablation area substantially improves the likelihood that all relevant nerve branches are effectively deactivated, resulting in more complete and durable pain relief.
Cooled RFA technology is approved by both the US FDA and the Thai FDA (อย.) and is used as a standard of care in leading pain management centres worldwide.
Who Is This Procedure Suitable For?
- Chronic knee osteoarthritis — patients with ongoing knee pain from joint degeneration, particularly those who are not yet ready for knee replacement surgery or who prefer to avoid it
- Persistent pain following knee surgery — including patients who have undergone total or partial knee replacement but continue to experience significant residual pain
- Patients resistant to conventional treatment — those who have tried oral medication, corticosteroid injections, hyaluronic acid (viscosupplementation), and physiotherapy without achieving adequate pain control
- Patients seeking a non-surgical, medication-reducing option — for those who want to reduce ongoing reliance on pain medication and achieve longer-lasting relief without major surgery
The Procedure
- The procedure is safe, precise, and typically takes 45–60 minutes depending on the number of nerves being treated.
- Real-time image guidance — the physician uses ultrasound guidance and/or fluoroscopy (live X-ray) to precisely locate each genicular nerve target around the knee in real time, confirming accurate placement before energy delivery
- Cooled ablation — fine cooled probe needles are advanced to each target nerve position; radiofrequency energy is delivered through the water-cooled system, creating a larger treatment zone than standard RFA and ensuring effective deactivation of the genicular nerves responsible for knee pain
- Total procedure time is approximately 45–60 minutes depending on the number of nerve targets treated.
Expected Outcomes
- Significant and sustained pain relief — most patients experience a meaningful reduction in knee pain; the therapeutic effect typically lasts 6 to 24 months, with individual variation depending on the severity of the underlying joint condition and the patient's overall response
- Improved mobility and function — reduced pain enables patients to move more freely, engage more effectively in physiotherapy and rehabilitation, and return to activities they had previously been unable to perform comfortably
- Reduced medication dependence — Cooled RFA helps patients significantly reduce or eliminate their reliance on ongoing pain medication, lowering the cumulative health risks associated with long-term analgesic use
Post-Procedure Care
- First 1–2 days: Mild soreness or aching at the treatment sites is normal and expected. This is a routine tissue response and typically resolves on its own within 1–2 days.
- Activity: Most patients can return to light daily activities the following day. Avoid strenuous exercise or activities that place significant load on the knee for the first 48 hours following the procedure.
- Pain onset: Full pain relief from the ablation develops gradually over 2–4 weeks as the nerve deactivation takes complete effect. It is normal to experience variable pain levels in the first 1–2 weeks before full benefit is felt.
Pain Management at Bangkok Interventional Clinic
At Bangkok Interventional Clinic, we focus on personalised, in-depth pain management tailored to each individual.
- All patients are evaluated and treated by a board-certified pain specialist, ensuring accuracy, safety, and effective care.
- Targeted interventional procedures for fast and effective symptom relief
- Patient education to support sustainable, long-term self-care
Our goal is to meaningfully improve the quality of life of every patient we treat. If you are living with pain that affects your daily life, the right diagnosis and the right treatment plan are where change begins.
